Plantar Fasciitis

I've decided to do an "injury of the week" post to explore some of the more common, running-related ones. To kick off the series, I figured I'd start with the most common injury I hear about in the store every weekend - Plantar Fasciitis.

What is it?
Plantar fasciitis  is simply an inflammation of the plantar fascia, which is a thick band of connective tissue that runs along the bottom of the foot and connects the toes to the heel. It is the most common cause of heel pain.

In general, Plantar fasciitis only affects one foot, and the pain is usually worse in the morning or after sitting for long periods of time (i.e., when the tendon is tight). Basically, it feels like someone is stabbing a knife in your heel, although some people complain that the pain is more in their arch.

What causes it?

• Excessive pronation
• High or low arches
• Over-use
• Tight calf muscles or Achilles
• Shoes that don't fit well or are worn out
• Other risk factors include age and obesity... also, it is more common in women (wonder if that's because more women wear tight / ill-fitting shoes compared to men)

What can I do to prevent it?
Calf stretches and towel stretches 

What can I do if I already have it?

• Rest rest rest...
• Ice ice ice... 
• Physical therapy
• Break up scar tissue (from past injuries) in the calf, Achilles, ankle, and/or foot (rolling your foot on a golf ball or tennis ball)
• Anti-inflammatories and corticosteroids
• Strassburg sock
• Taping your foot

What are the best shoes for it?

• Ones with good arch support... stability shoes if you over-pronate... orthotics may also be necessary.
• But, the most important thing is to REPLACE YOUR SHOES WHEN THEY NEED TO BE (the recommendation is every 400-miles).

Cryotherapy

Like Han Solo?! Well, sort of, although not for quite as long. Cryotherapy is like an ice bath on steroids. Instead of just icing you legs, athletes stand in a cylindrical chamber for ~2.5min while hyper-cold air is released all around their body. How cold is "hyper-cold"? Well, like -300 degrees (not sure if it's Fahrenheit for Celsius, but either way, that's cold). Why would you want to do this? Cryotherapy drops the skin-surface temperature to 30 degrees in less than a minute. Because this occurs so rapidly, the body's regulatory systems don't have time to kick in, and blood is immediately shunted to the core as a protective mechanism. Here, the blood picks up oxygen and nutrients.Then, when the frigid air stops, the body figures out where the blood "needs" to go (namely fatigued and damaged muscles). At least, this is the theory that the companies that make the $20,000 - $40,000 units are trying to sell their clients on. In reality, there hasn't been a whole ton of peer-reviewed research, and some say that there's not much difference between this treatment and a traditional ice bath.

32 Degrees

Unfortunately, Icy Hot can't solve all your problems... real inflammation requires real ice. After repeatedly freezer burning my leg a year or so ago (see conversation below), I've always been a little bit nervous about using actual ice, so I decided to look up the "proper technique" for icing an injury. First, lets start off with the things you shouldn't do:

• Ice before you run
• Leave ice on for more than 20 min (or if the skin looks red... this is a sign of frostbite)
• Give up after 1 day

So, what should you do?:

• Ice the injured area as soon as possible after exercising. Try performing an ice massage (apply ice directly to the injured area, but move it constantly). Elevating your legs also helps to prevent swelling.
• Ice for at least 10 min (15-20 min is ideal... but take ice off once you feel numbness). However, if there is not a lot of fat/muscle in the injured area (such as your toe), remove the ice after 10 min.
• Ice repeatedly (5x daily with at least 45 min between applications)

There are many "icing options" available (don't allow any of these to sit directly on your skin for extended periods of time):

• Ziploc bag with ice and water (the water helps the bag conform to your body).
• Paper cups with frozen water (peel away the bottom... and yes, I do realize that frozen water is ice, but I didn't want this to be confused with a paper cup full of ice cubes)
• Bags of frozen vegetables
• Ice packs (instant or reusable... don't believe them when they say that they can be applied directly to the skin)

Actual Conversation...

Chiropractor: What did you do to your leg?

Meghan: My ankle started hurting like 2 weeks ago for no reason...

Chiropractor: No, I mean why is your skin all discolored by your ankle?

Meghan: Oh... freezer burn.

Chiropractor: Meghan, PLEASE be careful.

 ... a similar instruction was given when he asked why my shins were all bruised after I had just recently got clip-ins :-)