Plantar Fasciitis: The Bitch is Back

In my first incarnation of this blog, I wrote a lengthy post about plantar fasciitis, lovingly entitled The Plantar Fascia - That Fickle Bitch.  Well, as Sir Elton so colorfully sang, The Bitch is Back.  Yep, I've been struggling with one of the Five Horsemen of the Runner's Apocalypse (the others being (1) "Runner's Knee" (patellofemoral pain syndrome), (2) illiotibial band syndrome (ITBS, which I have also suffered from), (3) achilles tendinitis, and (4) shin splints)).

For anyone else who has suffered from plantar fasciitis (which I'll call "PF" because it's a pain in the ass to type out), it isn't always an incredibly painful ailment (although it certainly can be), but it is an annoyingly nagging injury that is really, really hard to get rid of (short of just not running... which isn't really an option for me, since I have the Twin Cities Marathon and the WDW Goofy Challenge coming up).  And, if you're afflicted with this asshole of an injury, you're willing to try just about anything to alleviate, and hopefully heal it.

I am no exception.


So, over the course of the next few weeks, I'm going to provide summaries of what I have tried, what has worked for me, what has sort of worked for me, and what has been a bust for me.  Some of this summary of my treatment attempts will be in the form of product reviews (because I have bought at least 5 different products specifically for PF, and two other products that I bought for general injury treatment that I have used almost exclusively for PF treatment).  I plan on calling this summary of my PF journey something catchy like "The Bitch Chronicles" or something else clever.

And so you don't have to leave completely empty handed, I'll do a "mini" treatment summary today.

Ice & Ibuprofen

The two conerstones of soft tissue injuries.  Both help alleviate inflammation and pain.  Icing also has the added advantage of alleviating swelling and (after you stop icing) increasing blood flow to the area, which can help your body remove the bad stuff (scar tissue mainly) from the area.

Icing is one of the treatments that I think a lot of people forget about when it comes to PF.  But, I've been doing passive icing (e.g., where you just apply ice to the area and let it sit there) for pretty much the entire time I've had PF, and it really helps (it doesn't completely heal the plantar fascia, but it definitely alleviates swelling and pain, and over time can speed recovery).  I'll talk more about active icing (sometimes also called "ice massage" or "cold massage") in a later post.

A couple notes of warning about ibuprofen (actually there are probably several, but these are the ones I know about):
(1) You can take too much ibuprofen, and it can cause problems - the most widely known is that a lot of ibuprofen can cause ulcers.  But, a less well-known (and less common) effect is the effect on the liver.  If you start taking more and more ibuprofen (as PF sufferers can do), your liver may not be able to keep up, and it can lead to liver inflammation.  I think it is a pretty minor risk... but it is still a risk.
(2) You Shouldn't Take Ibuprofen Immediately Before Runs (particularly long runs or races) - this one is particularly tricky, since the primary purpose for taking ibuprofen is to reduce inflammation in order to reduce the liklihood of reinjury.  But, apparently ibuprofen use during long aerobic activities can cause hyponatremia (depletion of sodium, which can cause death in marathons and other long races), dehydration, and even kidney failure if you aren't careful.  This can be a particularly big risk if you are taking ibuprofen in hot or humid weather.

As far as I know, there aren't any negative side effects of icing (other than you should be careful for a few minutes after you ice because your muscles, ligaments, and other soft tissues will be tight until blood flow brings the temperature back up to normal).

That's all for now... happy running.

(DISCLAIMER: By the way, in case you didn't know... I am not a doctor, so there is no freakin' way that this should be construed as medical advice.  If you are having serious problems with PF, you should probably go see your doctor.  And if you've already seen your doctor and he or she has told you to do something else, then please listen to your doctor.  I'm just a schmuck with a blog.)