Plantar fasciitisPlantar fasciitis, a runner’s worst nightmare and tougher to cure than a teenage girl’s crush on Robert Pattison. MR walks you through the healing process Plantar fasciitis - the blight of many a runner. It’s the heel pain you get when you take those first few steps in the morning or after sitting for a long period. At first it goes away quickly and you will probably forget about the pain until the next morning, but left unchecked, this feeling of standing on a frozen pea (a bit like the sleepless princess, but without her enormous bed) in the morning starts to affect not only your running, but also your ability to live a normal life.
For those who have suffered, you will know this can end a running career or at the very least rob you of a long period of training. There are so many forums full of horror stories of people spending thousands of pounds on treatments including night splints, injections and orthotics, but this unique protocol that has worked on thousands of runners. The following step-by-step technique has been successful 100 per cent of the time provided the patient hasn’t been suffering for longer than six months. It is important to stress that this is purely anecdotal evidence (which might make the sceptics among you sit up and stroke your chin tentatively), but just ask any one of the runners treated who have been through it and you won't feel the need for any scientific stats to support these results.
The basic principle is to lengthen the tight structures in the foot, optimise the muscle function through massage and strengthening exercises and ensure the bony alignment and joints of the foot and ankle are improved. Seems simple doesn't it? Nothing contained within the programme is unique in its own right. It's simply the combination of these elements in the right time frame that delivers the results. In an initial session you should have an accurate diagnosis and first soft tissue treatment to your calf muscles and the base of your foot (not the heel).
The toolsMake sure you have these to hand: Running shoes by your bed Towel Scholl Orthaheel supports (use the information at http://www.scholl.com to select the right insert for your foot type) Strassburg sock (www.thesock.com) Ice
1. NO barefoot walking (even keep your trainers by the bed at night just in case you’re caught short).
2. Write the alphabet with your foot before walking in the morning or after a long time sitting.
3. Wear Scholl Orthaheel supports in your shoes (approx £22). There are different versions for normal shoes and for trainers.
4. Towel grabbing: 2 x 2mins per day (pull a towel along a smooth floor surface using just your toes and forefoot).
5. Calf and soleus stretches: 6 x 60 seconds per day (against a wall so you get toe extension).
6. Big toe extension: pull your big toe into extension wherever possible for as long as possible throughout the day.
7. Wear the Strassburg sock at night (this provides a gentle stretch to the fascia).
8. Ice the heel for 10 minutes after any prolonged period of work (long walks or time spent on feet at work, etc.).
9. Where possible wear your trainers - even if it means just to get to the office where you can change into your work shoes with the Orthaheels inside on arrival.
Once you have mastered all these points it’s time for the weekly treatments. Each week the soft tissue work will be increased into the calf and forefoot easing the pull on the plantar fascia origin on the heel bone - the sessions work closer and closer to this painful spot, but critically never directly over it.
The sessions can be quite sore and feel very deep, like a dedicated sports massage on the area. Each session also mobilises each of the small bone joints in the foot to get them moving, the same on the ankle joints.
Gradually the exercises become easier and easier to do and at about session three most clients are given specific running sessions to do (no running for the first three weeks though).
To begin with, run for five minutes, spend two minutes stretching the calf and soleus and repeat five times providing the pain doesn't escalate above a 4/10 (10 being the worst pain imaginable). If this goes well, repeat the full set after a two-day rest (i.e. run on Monday and again on Thursday). If this is still too painful, then drop the running to 3-minute periods and try to do just three sets with stretch breaks.
Gradually the running can be built up until you can manage 3 x 15 minutes with pain below 2/10. Some of you will reach this stage after five sessions of treatment and at that point a gradual return to training is prescribed. However, for many it takes the full 10 weeks.
Once this stage has been reached you will then be set training sessions for the next month before a review that will hopefully discharge you from treatment. If you have never been struck down by plantar fasciitis, building these exercises into your routine will help guard against suffering in the future. There will be health professionals who disagree with this method but a number of athletes have found success with this treatment. In a world of science and evidence based practice it is simply comes down to the ability to prove that one method is better than the current thinking. Words Paul Hobrough