Treating plantar fasciitis with minimalist shoes

by EJN Comments (4) Articles, Maintenance, Training

Guest blog by Camille Herron

As I’ve detailed going back to August, I literally “split my foot in half”, which started with bee stings (including one on the bottom of my heel). While we knew I had cracked the calcaneus, we didn’t know the extent of the damage to the soft tissue. I’ve been trying to comeback since October, and while the heel bone itself has felt fine, there’s been lingering “scar tissue” on my heel, which gives me ocassional pain (localized to the heel/medial heel) and limits my pushoff, foot spring, and foot strength. It’s tricky cause aerobically I feel fine and can run my usual easy day paces and mileage, but my foot is weak on hills and with speedwork. I can now sympathize with ~Ryan Hall, as he struggled to hit his typical speeds last year while dealing with PF.

I finally decided to get an MRI and see what’s going on, so we know how to treat it right. It turns out I have, as characterized by the radiologist, “moderate to moderately-severe plantar fasciitis” and a partial tear in the aponeurosis (the plantar attachment) with adjacent edema and thickening. That doesn’t sound good! I can’t imagine what they would have done with me had we gotten the MRI when the foot injury happened! I probably would have been put in a cast and not able to run for MONTHS. Here I am… I’ve already run 2 marathons with this foot!

What Normal Plantar Fascia looks like

My Plantar Fasciitis w/ partial tear in the aponeurosis and edema and thickening

Sooo… now that I know my problem is PF and have all this scar tissue that needs to be “stretched/worked out”…. LIGHT BULB moment.

The past 1-2 years, I’ve been gravitating away from my usual ~minimalist shoes/barefoot running (which I’ve been in for 9 yrs.- never had a PF problem) and wearing slightly beefier shoes (for me)– more along the lines of ~marathon racers/lightweight trainers. I thought this was good for my foot problem by helping to rest it and reduce inflammation. In hindsight, it probably was beneficial for the early stages of the healing process, but now that it’s ~healed and developed lots of scar tissue, I need to work my foot to stretch and strengthen it back to normal.

It felt like I got to a point where the ART treatments, self-massage/self-graston, golf ball, barefoot running (which I blogged about, has helped in the past), and stretching/strengthening, wasn’t making a difference, probably because I was in the wrong shoes for my 16-20 mile daily runs (which tightened it back up and led to massive scar tissue). I have so much scar tissue on that heel that I probably need more aggressive treatment and active-foot-use now. I’m up for recommendations on what to do and who to see (~Graston, dry needling, PRP/Prolotherapy, etc.). I actually did my undergrad Sports Medicine internship project on ESWT (which I got to sit in on with one of our patients).

I also must point out that treating PF totally depends on the person and trial and error of what helps. I read online about ~avoiding being barefoot, wearing supportive shoes, getting orthotics, etc.. However, as I mentioned, these things might help it to calm down/heal, but longterm… the scar tissue and plantar fascia needs to be stretched and strengthened back to normal length and functionality. Most people try manual and mechanical therapies done at home or with a healthcare specialist, while sticking with more supportive running shoes. However, I’ve been in flats/barefoot for most of my adult running career, so I’m comfortable trying this.

Anyone remember Puma H Streets? The shoes I trained in from circa 2004-2007.

My old Brooks T6s, which feel like high heels compared to my Inov-230s, but both are very flexible

I still have some very minimal shoes in my closet, 5K-10K type racers (and some street/retro shoes). When I started trying these out last week, it was instant relief! I was pretty stiff and sore though for a few days, since I haven’t worn shoes like this for a while, but after that adaptation period… I could finally get out of bed in the morning or stand up from sitting down, without hobbling around for a while. I’ve found that the key shoe elements for me right now are firmness and flexibility(and probably low heel-to-toe, as too much heel elevation “encourages” a heelstrike). My heel is also sensitive to how the insole and upper fits around the heel (nothing pressing into it) and doesn’t like arch support. I almost wonder if the scar tissue is pinching a nerve (Baxter’s nerve?).So far in the racing flats, it feels like my foot has gone from being “dormant”, like running on a stiff, peg foot… to coming alive! I can feel myself getting up more on the ball of my foot and pushing off more forcefully.  The flexibility of the shoe is very key for me, as my foot needs to be able to roll, bend, and toe-off with ease (since my plantar fascia is so tight and sensitive). It feels like my arch is trying to relax and flatten, but the plantar fascia is still too tight. I can sometimes feel my heel/arch spasm and relax mid-run, probably because the scar tissue is gradually being worked out. As my friend, Joseph, pointed out– it’s all about getting that “proprioceptive feedback”, as the foot tries to straighten itself out.This is where I stand right now. I hope by sharing my experience, it will help others suffering with chronic PF to “look outside the shoebox”. I’ll see how the next month goes in the more minimal shoes, and hopefully I can find the right healthcare professional to try some more aggressive treatment methods. I haven’t figure out the right shoes for the marathon yet. My next major race is the Mercedes Marathon, so that will be a good test to see if my foot is getting back to normal so I can run my normal speed.**Disclaimer** I am not a physician, so it’s best to seek out medical advice from a professional first. What I’ve shared in the article above is purely my own experience.

Camille Herron is a 2:37 marathoner and a heck of a blogger. Be sure to check out Camille’s blog, which is a great source of info.

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4 Responses to Treating plantar fasciitis with minimalist shoes

  1. Vancouver Orthotics says:

    Thanks for sharing this information and your perspective. Plantar fasciitis affects many people and conservative options should be considered and made available.

    Dr. Michael Horowitz

  2. Amy Everpean says:

    Wow great post! I recently bought some shoes from for my plantar fasciitis and totally love them! Glad to see you are still doing what you love!

  3. Beau W says:

    Try cascade therapy. I was a college ball player and couldn’t give up the game and still won’t even suffering from PF. I consulted my physician and after several attempts we tried “cascade therapy” which is essentially platelette therapy. They take your white blood cells and reinject them into your affected area. It worked wonders for me and I’m able to run long distance and play basketball daily with no pain. With insurance I paid $250 for the procedure. Good luck!

  4. Of all the treatments that you are thinking about trying, I would try graston. It is more effective in my opinion as compared to ART for plantar fasciitis in particular (but I love ART for nerve entrapment/hip/shoulder issues). Good luck! How is the pain as of now? Any improvements?

    William Prowse
    Author of Plantar Fasciitis Survival Guide

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