some painful advice?

[Christine Racine]

Hi out there – anyone who has had bad PF rq. a cortisone shot, or some other body part for the shot?

 

I’m in a conundrum as it were. As you may know, I had a cortisone shot in my foot and was given clearance a few weeks later to slowly start running, which I did at 5 a.m. on the green light day. I felt good, waited a day, ran again, didn’t feel good. Back to icing, rolling, resting, blah blah blah. My foot has good moments mixed w bad moments since that run, but not as bad as before this started and it is seemingly getting better, albeit slowly, since the second “bad” run….so, the doc says I can do another cortisone shot if I want. Aside from the fact that the shot hurts like a ******, I’ve read that shots can be harmful to the ligaments and aren’t riddled with success rates, etc etc…I’m trying to pay attention to how my foot feels and act accordingly, but I don’t want to fall back to what got me here, either. Oh, and I’d like to flipping run again!!!!! Stat!

 

Has anyone had success with multiple cortisone shots, since the internet is laden with opinions the other way? Other than that, I know its just icing, stretching, blah blah blah…..

 

#patiencewearingthin

#disgruntledrunner

 

Thanks for any advice!

[Jeff Walker]

Tendons and ligaments have very slow remodeling rates. Cortisone will likely just slow it more. Of all the injuries with mixed (and contradictory) advice on what "works" PF is among the worst. Lots of anecdotal stories about barefoot running have tended to influence my thinking. Not running in minimal shoes but barefoot on a soccer field. Totally opposite of course from the traditional approach which is a built up shoe + orthotic. I guess I would try running on a soccer field barefoot. Tiny amounts. For a many, many weeks. It will not heal quickly. Do this until the snow falls, then ski, and you'll be golden in Spring 2013!

Question - on a scale of 0-10, how much does it hurt at the beginning of a run? Does the pain get less during the run? How far can you go before you stop running? For the scale 2=annoying, 4 = uncomfortable, 6 = dreadful, 8 = horrible, 10 = agonizing. 

I frequently get mild PF. It's a little stiff first thing in the morning (classic). Pain maybe 4/10 at the start of a run but by end of mile 1 or 1.5 latest the pain largely disappears so its never kept me from continuing training as normal. I wouldn't run on something > 5 and would only run on something ≥ 4 if I knew it would be only for a few minutes

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[pathfinder]

I have experienced the pain and nuisance of PF and my view is stay
away from cortisone. I view it as a mask rather than a cure. If the
pain is masked, then you could prolong the healing process by doing
too much too soon.
Listen to Jeff, I did similar to what he did (except I didn't ski,
snow shoed instead). Ph takes a long time to heal but as long as you
pay attention to the pain level, you can run through it ......but no
racing. I also ran with a shorter stride and trying not to push off
hard with my toes. One other thing I used was a sock that was
designed to pull the toes up at night when sleeping and still icing
after runs.

On Aug 15, 8:31 am, "Christine Racine" <crac...@maine.rr.com> wrote:
> Hi out there - anyone who has had bad PF rq. a cortisone shot, or some other

> body part for the shot?
>
> I'm in a conundrum as it were. As you may know, I had a cortisone shot in my
> foot and was given clearance a few weeks later to slowly start running,
> which I did at 5 a.m. on the green light day. I felt good, waited a day, ran
> again, didn't feel good. Back to icing, rolling, resting, blah blah blah. My
> foot has good moments mixed w bad moments since that run, but not as bad as
> before this started and it is seemingly getting better, albeit slowly, since

> the second "bad" run..so, the doc says I can do another cortisone shot if I

> want. Aside from the fact that the shot hurts like a ******, I've read that
> shots can be harmful to the ligaments and aren't riddled with success rates,

> etc etc.I'm trying to pay attention to how my foot feels and act

> accordingly, but I don't want to fall back to what got me here, either. Oh,
> and I'd like to flipping run again!!!!! Stat!
>
> Has anyone had success with multiple cortisone shots, since the internet is
> laden with opinions the other way? Other than that, I know its just icing,

> stretching, blah blah blah...

[Christine Racine]

Hmm, I’ll use your pain threshold as my guide. It has varied to date. I can
handle the discomfort, actually, I’ve stupidly run on it when its been well
over the 5! Learned that lesson…..hence, trying to really weigh when to rest
vs run it out. The problem is after that second run, its hurt since, so not
just during the run. I don’t want to further the cycle. But I’d like to run.


The doc says the cortisone will speed up the process of it getting better,
vs slowing it…..I’d rather not get another one though unless I really have
to i.e. back to 10. I'm not a fan of taking meds as I concur with the mask
theory - even when I have the flu!

Hmm, ok, I guess I'll be resting and stretching awhile longer. With that
said, anyone want a Stonecat marathon bib? I assume I can transfer now. I'll
check into if anyone is interested.

sigh.

Oh, and I have the Strassburg sock - wear it every night! Makes me feel like
Hannibal Lector!

[Amy Tobalske]

I have had multiple cortisone shots in my shoulders in the past. I, too, was warned of using them too often. They work immediately, but not great for the body. 

Perhaps resting is best right now. Can you bike or swim do yoga w/out pain? Frustrating to not do what makes you feel good. 

 Hang in there.  You will be back.  

Sent from my iPhone

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[Christine Racine]

Yoga and elliptical. But not nearly as fun w/o all o' you.....

There is already a maybe from someone on Stonecat which is sat nov 3 btw if any other interested takers...

[Jeff Walker]

Plantar Fasciitis

A Degenerative Process (Fasciosis) Without Inflammation

1. Harvey Lemont, DPM*, 
2. Krista M. Ammirati, BS* and 
3. Nsima Usen, MPH*

+Author Affiliations

1. ^*Temple University School of Podiatric Medicine, Philadelphia, PA.

1. Corresponding author: Harvey Lemont, DPM, Temple University School of Podiatric Medicine, Eighth at Race St, Philadelphia, PA 19107.

Abstract

The authors review histologic findings from 50 cases of heel spur surgery for chronic plantar fasciitis. Findings include myxoid degeneration with fragmentation and degeneration of the plantar fascia and bone marrow vascular ectasia. Histologic findings are presented to support the thesis that “plantar fasciitis” is a degenerative fasciosis without inflammation, not a fasciitis. These findings suggest that treatment regimens such as serial corticosteroid injections into the plantar fascia should be reevaluated in the absence of inflammation and in light of their potential to induce plantar fascial rupture. (J Am Podiatr Med Assoc 93(3): 234-237, 2003)

[Jamie Anderson]

Worst running injury ever, aside from the dreaded pneumothorax. I know I've already talked with you about it a few times, but can't stress enough to give the barefoot on the soccer field route a try. Nice and slow and steady as she goes, as Jeff eluded to. Have you seen Dr. Jamie or someone else to determine a root cause? I know he helped me figure out my problem was heel striking. Once I adjusted my gait, all was well with the world within a few months. 

-Jamie

[Christine Racine]

Tots gonna hit the fields. Just wanted to "rest" again this week. 

I think my gait is a nightmare right now. My body adjusted to the pain in my foot and I could feel myself returning to it on that second run. Even tho I was trying to focus on short strides and midstriking. I'm going to have a gait analysis in a couple of weeks. PT thought I should try running a bit again to make it a useful analysis. 

Doc mentioned orthotics which I am also not interested in at all. 

If you guys hit TB Tuesday and I make it too, maybe I can catch you in fields and I can watch you run too. See what I think I should be doing!

[Joe Wrobleski]

Have you switched running shoes that may have caused you to change your gait?  I developed a rather painful bursitis in my knee from changing running (road) shoes.  The "bur" is still on the tendon, but it stopped hurting after about a week once I ditched the new shoes and went back to the other model of trainers.

 

Joe

[Valerie Abradi]

I wish I had been blogging back when I had PF, more to know the actual time versus what I remember as the duration, but...
My PF seemed to come on when I switched between winter shoes (slightly higher heel to toe dif.) back to my regular shoes.
By the way, this was back in my roadie days.  I ran till I thought it better to not and tried the stretch, ice, rest thing.  Being
the impatient person I am, who goes crazy not running, that only lasted a week.  Then I ran any way, but still stretched all the
time and iced when I could.  I read an article on PF and ART (active release therapy).  It seemed like a crock since it touted being
able to cure PF in one treatment.  I saw a sports dr.  He had PF in both feet.  I asked him about ART.  He'd read the same
article and had the same reaction I did, but said if I tried it to let him know. 

Since I'd decided to run anyway, I did a race around the Back Cove.  The guy who was set up for the post-race massage had a
sign that he preformed ART.  When I was inquired, saying I had PF, he was so psyched that I'd heard of it (at the time he
was the only one in ME doing it).  He said he wouldn't recommend it pre-race, but to see him after.  Which I did.  Long story, slightly
shorter, it worked with one treatment.  I called the sports dr. back.  He said he'd tried it with no success, but it seemed to be working
for about 1/2 his patients.  I never changed anything about the way I run (confirmed heal striker) and have been fine since.

Within the past year I did read an article that says most PF will resolve in a year no matter what is or isn't done. 

[Blaine Moore]

I'd say take everybody else's advice - mostly rest, do some barefoot walking when it isn't too painful, then slowly ramp up to barefoot running. If using soccer fields, do not use the soccer fields by the Back Cove...lots of fleas from the doggies would love to bite you. I assume you'd just head over to the high school next door anyway, but thought I'd give fair warning. (Learned that the hard way a few years ago.)

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[gIANt]

I've only had minor PF but I found that rolling my foot on a frozen water bottle helped, as well as rolling my foot on a golf ball. I would do this while sitting at my desk at work.

 

And I'd take your SC number in a heartbeat. Of course I'm sorry that it looks like you won't be able to run it yourself :(

 

gIANt

[Jeff Walker]

Yes, I'd roll my foot on a lacrosse ball. They are the perfect size.

[Erin Moore]

We've already talked about this, but when I got my PF, it was in the fall - I was training for the Maine Marathon.  Not sure why it happened other than I'd stepped up my training a whole lot that summer.  Anyway, I did not get any cortisone shots.  Since the marathon was out, I pretty much gave up running for a few months and started swimming.  Great way to keep in shape with no weight on the feet.  I also rolled with tennis? balls.  And iced.  Had not learned of the frozen water bottle trick yet.  I also started using Superfeet as that was the common cure back then.  Unfortunately, for the next two or so years, my PF came back to haunt me whenever I tried to train too many miles (as you know, once I hit 15 or so miles, I'm on my feet a long time!).  Interestingly, I have had virtually no problems with it since I started trail running.

Sorry that you are having to deal with this!  As long as the weather is nice, we will be at TB on Tuesday.  If you are there, I will either run the fields with you or watch you do it while I am on baby duty.

Erin 

[SusannahB]

Random life lesson for PF:  lay off the flip-flops, clogs and high heels.  They put strain on your calf-- whose tightness is the original source of most PF troubles. 

 

Good luck!

-Susannah