Running through plantar fasciitis

In my last blog I listed off all my current injuries and niggles and the most worrying was the horrible pain I’m feeling in the arch and at the start of the heel in my right foot. I self-diagnosed it as plantar fasciitis back in April and I talked about it in a blog at the time: Is running the most injury prone sport? I said I was dreading that it was returning and unfortunately, I was right. It’s now back with so much angriness that it’s virtually all I think about.

Most runners are familiar with plantar fasciitis (PF) – if they haven’t experienced it, they almost certainly know someone who has. In my running club, the Ealing Eagles, there is a collection of us who have supported each other from time to, mostly with tea and sympathy, through long bouts of PF because very frustratingly it can last for months, in some cases years.

When I say to people I have PF most non-runners look confused. Then I usually say, “they used to call it Policeman’s Heel”, which doesn’t really help much with their confusion, but I seem to keep saying it anyway. The Wikipedia entry is actually quite useful here. To summarise, the plantar fascia is the connective tissue that supports the arch of the foot and PF is when it’s angry. It’s associated with increased load, so that could be running, standing for long periods of time (just like the old bobbys on the beat hence the policeman’s heel) or obesity. There have been links made with tight calf muscles and also with people who are flat footed. Unfortunately, there is no really clear scientific evidence on what causes it and that also means that treatment is varied and unreliable.

Weirdly, around the same time the PF developed I got a verruca in virtually the same painful place on the sole of my foot. “Old school” is what people usually say when I tell them this. I’m not sure how or where I got it. Even though I am now old, I haven’t had one since I was at school and just like the PF, it won’t shift. I’ve tried two over the counter methods of attack. I’ve also tried ‘doing nothing’, as the NHS website suggests, but it’s still there, and it feels like a needle, piercing through the bottom of my foot.

I have mentioned that I have had PF previously, and that was back in 2014. I actually trained for and ran a marathon with it. I even got my marathon PB so I couldn’t argue that it impacted my performance. But after I’d ran my race, within a couple of weeks, it got much worse, and I was laid up for around nine months. In the end, I had a steroid injection and after a few weeks of rest, I started gradually running again and it was gone. I suddenly became the advocate for this miraculous PF treatment and encouraged a few friends to get an injection. It didn’t work for them. I had one friend whose PF only disappeared when she got pregnant. She jokingly became an advocate for that form of rather extreme treatment – I think some of the men felt rather disappointed it wasn’t an option for them!

In recent years, shockwave therapy has become a popular form of non-evasive treatment for all sorts of sports injuries. A previous blog ‘Weekly torture sessions and thrice weekly mirror gazing’ I go into a bit more detail about what it is and how I was having it on my troublesome hip (now healed). There is increasing evidence that it can also help people with PF so back to the sports doctor I went for six more weekly torture sessions once he’d confirmed my self-diagnosis was correct. Once again, every Monday, I lay, this time on my front, squeezing a pillow and repeatedly reading the letters printed on a plug socket on the wall ahead – anything to try and not think about the pain.

I had high hopes, but seven weeks later, I am definitely not cured. In defence of the shockwave therapy, I haven’t reduced or even maintained the impact I am putting through my plantar fascia, I am absolutely and unquestionably hammering it. London Marathon training is the only reason I am doing all this so I’m not going to stop that! As my doctor points out, we don’t really know if it would be considerably worse without the shockwave therapy, it could even be keeping it at bay.

In my last blog, I said the PF pain was hovering around three to four out of ten. It’s probably gone up a notch but the worse of it is that it is always there. When I’m walking, running 20 miles even when I’m laid in bed. I can tell that it’s making me run slower and possibly even forcing me to adapt my running gait. This isn’t good as I could end up injuring something else.

And before anyone starts shouting at the screen, yes I’m doing everything else; icing, rolling on a ball, strengthening my calves, stretching my calves, drawing the alphabet with my toes before I get out of bed, always wearing cushioned shoes or slippers and anything else out there. I even bought one of those ankle splints for bed that keeps your foot flexed. It was so uncomfortable, and I just kept removing it in my sleep.

Last week I didn’t do the mid-week ten miler on my training plan because my foot was too sore to walk on. I was also working away and it meant a 5:30am start in lashing down rain, in a city I didn’t know, so I decided a bit of rest might be a good idea. I did manage 18 miles a few days ago but that confirmed that I am now running through constant pain and it’s not going to get better.

Next stop is a podiatrist. Recommended by the sports doctor and physio. A specialist running one but I’m being realistic. He isn’t going to give me a miracle overnight cure. Although as a plus, I am optimistic that he might be able to do something about that dastardly verruca!

With only five weeks until the marathon, I am now debating whether I stop running completely at some point and rest until race day. The theory being that I have done a bulk of training, enough to get me round, and the rest might help. The downside to that is the rest might not help anyway and I’ve sacrificed some key training that might have been quite valuable. I didn’t go into this to just ‘get round’. And at one point do I stop training? Four weeks out, three, two? When I had PF last time in my left foot, I ran a marathon, quite fast and it was only when I stopped marathon training that the problem got much worse…

The other option is that elect to have another steroid injection. Whilst it hasn’t always worked for others, it did work for me last time on my other foot. However, I will need to take two weeks off running and ideally gradually increase the training load. And there is nothing gradual about running a marathon.

So, for the time being, I’m just carrying on, ticking off the training runs. Thinking about what to do. What would you do? Answers on a postcard. Until next time… thanks for reading.