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.