Plantar Fasciitis

Please read first

You will find on this page many notes, advice and my personal opinion on how to quickly recover from Plantar Fasciitis. Please take these notes as simple information. I am not a doctor and I have no professional qualification to treat such a case. Most of the notes you will find here are based on my personal observations of my own body. Some advice displayed on this page worked for me and might help you too, some won't because your body is different and won't react the same way. I strongly advise you, before trying anything, to consult your physician or a podiatrist and get a professional opinion. Your problem might be much more serious than you think!

As of this day I consider myself completely healed from plantar fasciitis, after what I estimate has been a 2 and 1/2 year-recovery period, from the day of the injury up to completing a marathon.

 Enjoy your time here :)

Contents

What this page is all about.  
How a couple of runs brought me from marathon level to not being able to run 5km painfree.  
Even when it does not feel good, you may still have a chance to escape this dreadful fate if you react quickly!
Recovery is long and painful, for the body as well as for the mind. Here is how I went through it.
Recovering tools, gadgets, massage items... I tried most of them! Here's what really helped me. 
The pressure of starting from scratch again.
What should you do to avoid it and what I'm doing to never get it again.
Useful resources that helped me.

Ready? Let's hit the road!

Introduction

Hi and welcome on yet another page about the mysterious case or the horrible nightmare of plantar fasciitis, depending if you are a doctor or a runner! Don't worry. I won't give you here an in-deep explanation of what plantar fasciitis is or the usual advice on how to recover from it. You can find more than enough information on these topics everywhere (Internet, books, your physician, etc.) Feel free to browse through the References section of this page for some resources that helped me the most.

 Plantar fasciitis is different from one person to the other. What I really wanna do is talk about my own case, tell you my story, to convince you there is a way out, there is light at the end of the tunnel, and it's not that difficult to keep this plague far away from us!

 Note that when I am writing there lines, I am still actively recovering from it, so I have no guarantee but my own motivation that everything is gonna go according to the plan! I will update this page along my training up to my first ultramarathon, when I will consider myself healed!


1 - How I got plantar fasciitis

You can get plantar fasciitis for a lot of reasons: foot abnormality (flat or high arches), obesity, pronation, intense training, bad shoes, not enough rest, and much more. But in the running sphere, there usually are 3 or 4 threatening factors, and I am the lucky guy who won the jackpot by collecting them all!

1.1 - Old shoes

I was so in love with my old pair of Adidas, which supported me for 42,2 km up to my first marathon victory, that it broke my heart to change them. Keeping up my training, they soon scored more than 1000km, whereas everybody advise you to change them after 750km. I was still feeling good in them and thought this was just a marketing trick to make you buy more shoes. 

 What I didn't realise is that, although looking good on the outside, my old Adidas were worn out on the inside and did not cushion my steps as good as before. As a result, my feet were getting more impact from the ground, which eventually made my PF case worse.

1.2 - Drastic increase in your weekly mileage

June 2015, after scoring a new PR at Potsdam half-marathon, I was looking for a new challenge. Running a trail marathon or ultra started obsessing me and I decided to get to work. Browsing through the Internet, I found a nice training plan preparing for a first 50k in the mountains. Awesome! Well it surely was, but certainly not suited for a casual runner. It was almost a year after my first marathon and I had just trained for a half, which means about 30km a week. This new plan increased my mileage to 50km a week!

 But who cares, when you are motivated... and as dumb as a tree! At first, I did not feel bad, but getting out 3 days in a row for 10k runs, followed by a 20k on the week-end was exhausting. I ran like this 2 weeks before PF hit me. I'm not sure this increase in my weekly mileage was the main cause, but it definitely did not help. Therefore, you should be very careful how much you run.



1.3 - Hill running

As I said, PF is usually occuring for various reasons happening at the same time. But if I had to guess what really started the engine, it would be hill running. You see, not only did I picked up an ultramarathon as my next goal, barely one week after running an intensive half, but I thought it would be fun to run it in the mountains. That's why I started running once a week on a nice little (but steep) hill close to where I live.

 At first and as usual, everything was fine. Better than fine! I was climbing mountains, building up my legs for the heights, three steps from the UTMB!  But I got too excited and my last session was pretty intense, climbing up and down the hill until my legs and lungs were burning. The next week, I jumped into my shoes and went out for a long run. After 10km on the trail, I felt a sudden pain at the base of my left sole, right where it connects to the hill. Now any wise runner would stop immediately and rest his foot for a few days, even without any knowledge of PF! Instead, I convinced myself it was just sore muscles and kept running. Yes, I can be THAT stupid! By the time the pain intensified and I finally understood sth just wasn't right, I was 10km away from home. I should have stopped and taken the sub back, but I kept on running, trying to minimise the pain by landing on my forefoot, until it became unbearable. I finally took the sub for the last stations. 

 I didn't know it yet, but I had just run my last long run of the year, and it would take me another one to run long again.

1.4 - Not enough rest

It took me some time, but I recently realized, looking back, that my injury may have been (primarily?) caused by a lack of resting. I had just finished an intense training with many sessions of speed work and ran the Potsdam half-marathon faster than ever, scoring a new PR. But who needs to rest after a half? Well, as it turned out... I do!

 As I said, I resumed my training the week after, jumping from 30 to 50km a week. I had already run 50k a week before and it was ok. But this time my body was tired, my foot had just endured 21km at an intense pace and in very bad shoes. A full week of complete resting, even two maybe, would have made the difference and I might not be injured today. I knew the importance of resting after a marathon. But I didn't figured out that the distance wasn't as important as the effort you put into your run. You may need just a few days of rest after a slow Marathon but two weeks after an intense 10k. You don't know how long you should rest? Then listen to your body!


2 - How do you know you got it and how to react

Unlike many medical cases which may be tricky to diagnose, PF cases are usually crystal clear. Because its symptoms are very specifics and also because, looking back, you will quickly understand what you've been doing wrong.

As I said before, it started for me during a long run with a rushing pain and burning sensation at the base of my left foot, where the sole connects to the hill. It was sudden, painful, unlike anything I ever felt before. I understood that sth wasn't right and that I should stop running immediately and get some rest. That's what I did... well, right after running 10km back home!



No need to have my foot examined by a physician. As I said, PF symptoms are quite obvious and, looking back at the new exhausting training plan I had just started, I knew I had crossed the line and needed to take it easy from now on. But I didn't know it just wasn't that easy!

If you never had PF or don't really know what that is, I strongly recommend you to watch a few videos and read some articles or blogs on that topic (but ain't that what you are doing right now?). First, so you can recognise the symptoms when it strikes and more important, so you know how to react. Indeed, when the PF threat is upon you, the first days following the injury are critical and will determine if you need 6 days, 6 weeks or 6 months to recover!

Indeed, PF has a very nasty way of settling down in your feet. As I said in the introduction, I won't bother you here with an in depth study on that subject. But here's an interesting fact about PF, certainly the most important information to help you understand this plague, and strangely something people rarely talk about. I first came upon it while reading Paul Ingraham's in-deepth study (see References): PF is usually considered an inflammation of the tissue band joining hill and toes. This is incorrect. Most of the time, inflammations disappear after a few days of rest and proper medicine. That's why, like most unfortunate people sharing my condition, I decided to take a week of rest, thinking it will go away.

One week after my injury, I spent the first week-end of July in Prag and couldn't resist getting out for a run with the wife and brother-in-law. I ran about 9km in my old marathon shoes, including some steep hills, before pain rushed back and forced me to stop. Now let's jump a month later, mid- August, when I stepped outside for a short run: 1 month rest, new shoes and a flat smooth trail. I could barely cover 5km and I had to take the sub back home.

How do you explain this? If PF were an inflammation, a month of rest should definitely improve my condition, not make it worse! That's why we shouldn't think of it as such. As Paul Ingraham explains in his study, PF is much closer to a necrosis than to an inflammation.


A necrosis... That's not a happy word. We have it in French too and it makes me think of spider's bites or humans turning into zombies! Was I getting a zombie foot? A necrosis is basically a living tissue (like our flesh) dying. Which means that this tissue band inside my sole was hurt so bad, that it started degenerating instead of healing. I could rest as much as I wanted, there was no escape. I had now to get through the long and painful healing phase, not knowing if I would ever be able to run again and when.



However, had I been better informed (by reading a fine blog like this one, for instance), I might have reacted properly and avoided this unfortunate fate. As said, the first hours and days right after getting hit by PF are critical. The tissue band in your foot is hurt, but depending on how bad this is, you can try to prevent the dying and regenerating process to happen. Therefore, the first thing to do when you get the first symptoms of PF is to start an active and intensive recovery phase. Instead of resting on your couch munching on chips, ice your foot and stretch your calves regularly, apply some Voltaren on your sole and so on. See the next part for more recovery advice.

If you react quickly and work on the damages actively, you may get rid of your starting PF in a few days. However, if you don't do anything and let the damaged tissue degenerates beyond a certain point, you're up for a few months recovery! Once initiated, the whole tissue dying and rebuilding process is long and stressful, forcing you to a resting period without running!

3 - How I recovered

It is now official, you cannot run more than a few km without excruciating pain, your foot is complaining all day long, you are afraid of taking your first step out of bed every morning? Welcome to the vip club of plantar fasciitis enthusiasts :) No escape, no turning back, you will have to face the long and stressful recovery time. Cheer up, we will get through this together. There is light at the end of the tunnel and if you stick to a careful and wise recovery attitude, you will be back on the trail in no time.
“That which does not kill us, makes us stronger.” - F. Nietzsche

3.1 - Stop running

That's the first step. If you ever want to run again, quit running. Ironic, isn't it? It is the simplest yet most difficult step. Your foot is injured, your body needs rest, just accept it. Nobody's invincible and you are heading towards a world of pain and disappointment if you think that continuing running will heal your foot! It won't, it will just make it worse.

That's why the first thing to do is to get some rest. Keep your foot work to a minimum so it is able to recover. Some people carry PF cases all their life, because their daily activities and resting time are unbalanced and their feet never heal. You sure don't want that! Therefore, get off your feet as often as possible! Fortunately, I am working at my computer all day, which gives me plenty of resting time.

The injured plantar fascia tissue needs time to rebuild. A lot of time. Some says 3 to 4 months, some says a year, and I heard more. I think it depends how bad your case is and how active you are everyday. As for me, it took me 6 months of rest, punctuated by a few unsuccessful running trials, before I could resume training and build some mileage.

"6 months, are you crazy, I can't stay that long without running!" you may think. It is indeed a very hard thing to do. When you are used to running 3 or 4 times a week and up to marathon distances, as I was doing, switching to a 6 month rest is like asking Rocky to quit boxing and switch to ballet! Running is my way of decompressing, from my stressful everyday life. After one week of resting, I was already feeling tense and everything was driving me crazy. The key for that is to make good use of all this spare time we have. And that's when cross training becomes so important.

3.2 - Cross Train

This is not a necessary step to recover from PF, but it could become one if, like me, you can't imagine resting for six months with no activity whatsoever. By constraining yourself to a period of total rest, not only will you feel irritated and off balance in your everyday life, but you will also increase the risk of giving up and resuming your training too early. The key is to introduce wisely some cross training, which is not making your injury worse, of course. This way, you will stay active, keep up your cardio and fitness level and discover new healthy activities. Injured bikers or runners for instance use the extra time to improve their swimming skills and join a triathlon event.

I did not feel like swimming or pumping up weights at the gym, so I started biking. I broke open the piggy bank and bought a cross bike, to be able to go anywhere, roads or trails, not forgetting a good helmet! I enjoyed it right from the start, as it brought me back to my favourite roads. I was able to cover more distance and explore new areas, plan exciting routes for later, when I'll be back on my feet. Although it did not push my body as much as running, it was nice to get out for some exercise.

To make it an even better cross training choice, I bought a baby seat for my kid and took him everywhere with me, he was delighted and came to me everyday waving his little helmet and asking for more :) My wife was training for her 1st marathon at that time and we supported her during her long runs, papa and baby coach on the bike carrying food and drink supplies! That was a great time and it make it definitely easier to forget I was unable to run at all.

4 - Things that work, other than don't

When you got PF ans starts browsing about it, looking for tips to help you recover quickly, you are often submerged by the flow of information. Hundreds of websites claiming to have "the solution", thousands of videos to "get rid of plantar fasciitis in seven days" and millions of expensive tools and gadgets who are supposed to cure your feet miraculously if you open the wallet. You will soon realise that there is a whole business built on your misfortune, and in spite of that, you will undoubtedly buy some of them, hoping they will help, even a little. 

 It happened to me too and I tried quite a lot of things! As I said, you can find more than enough information about recovering methods and tools on the internet. I recommend you to start with Paul Ingram's e-book on the subject, which helped me a lot, as it debunks a lot of ideas and useless solutions (see References section). Here is a list list of what I tried and what worked for me (or didn't):

4.1 - The orthopedic soles

Surely the most efficient one. If  you should start with one thing, this is it. Your foot is tired, it needs proper arch support and good cushioning  to heal. Most of everyday shoes lack both. You can find generic orthotics everywhere (sports or shoe stores, pharmacies, online), but I would strongly advise you to have some made for your feet. Having tested both, I can guarantee you that the difference is huge!
  • How much: They can be pretty expensive. Fortunately for me, orthotics are partially covered by the health insurance in Germany and cost me only 20€.
  • Where: I asked my doctor for a prescription and had them made by a shoe specialist.
  • When: I started using them all the time, during the day, at work, while running and even at home (in my slippers). Stay away from barefoot walking at all times! After some time, I didn't use it in my running shoes anymore, as they were not made for that and good running shoes usually offer enough support.
  • Remark: I started using both orthodics, although having PF on my left foot only, and noticed some light pain in my right foot. Therefore, too much support seems to be unhealthy too! If your foot doesn't need it, don't wear it.


4.2 - The night splints

I read a lot about it and finally decided to try it. Healing my foot while sleeping seemed to be a pleasant idea. I tried the famous "Strassburg sock", which didn't work at all (it was pulling on my toes more than on my foot), so I exchanged it for a dorsal night shin. It is supposed to be less effective than the full splints (ski-boot style), but less bothering. The hard plastic part is on the top of your foot (hence dorsal) and hold it in a 90° angle while you sleep, to keep the fascia stretched. You avoid this way the morning pain of the first step.
  • How much: Prices can be very different, depending on the model. A dorsal one like mine costs like 30€.
  • Where: I ordered mine on Amazon, but specialised stores might have some models too.
  • When: wear it every night, especially after running days, as long as you feel some numbing or pain when stepping in the morning. I just got used to mine and wore it for about 6 months.
  • Remark: Adjust it carefully. If it's too tight, it can cut the bloodstream in the foot, slowing down recovery, which is the opposite than what you want!

Résultat de recherche d'images pour "voltaren"

4.3 - Voltaren and NSAIDs

When you are hurt, the first reflex is generally to swallow some pills and hope for the best. I'm not a big fan of that, as pills usually do you more arm than good. My useless doctor prescribed me some anti-inflammatory (ibuprofen) and some diclofenac (the same component you can find in Voltaren, but as pills). I took the ibuprofen for some time and I still do, when I have back pain or massive muscle pain after long runs. It helps recover. However, I ditched the diclofenac, as it can have dangerous secondary effects, when swallowed as pills. Instead, I used it locally, rubbing Voltaren gel on my foot. I don't know if it helped, as PF is not an inflammation, but it did no arm either.
  • How much: Both are cheap, NSAIDS sometimes even covered by your health insurance.
  • Where: In your pharmacy.
  • When: Read the instructions and discuss the right posology with your doctor. I took one 800mg ibuprofen pill twice a day (after a meal). About Voltaren, I put some on my injured foot every morning and evening, eventually just after long runs.
  • Remark: Go easy on the pills, it helps your body recover, but poison your kidneys on the other side. Your body is more than capable to recover without it. Just drink a lot of water, massage your muscle and trust mother nature :)

4.4 - The foam roller

Running can be a very stressful activity for your muscles. While providing the energy you ask of them, they will produce and fill up with lactic acid, a toxic waste responsible for sore muscles (usually at their peak the next day or two days after a run). To get rid of it, you need to drink a lot of water and massage your muscles. Ok, but visiting your massage therapist after every run could get pretty expensive! That's why the foam roller is gonna become your best friend.

  • How much: Prices vary a lot, but as usual, you don't need to pay a lot for a good model. Mine was 30€, as it is made in Germany, but cheaper models are equally good.
  • Where: Any sports or fitness store.
  • When: I use mine twice a day, mornings and evenings, when I have back problems. Else, I use it mainly after long runs, to recover quickly.
  • Remark: Don't go too hard on it right after long runs, as your muscles are under a lot of stress. It's most useful on the two following days.


4.5 - Balls, rolling pins, massage tools

One of the first (and maybe best) advice you will hear to cure your PF is undoubtedly rolling a golf or tennis ball under your foot. Indeed, this stimulates the bloodstream in the fascia and triggers the healing response. A whole bunch of massage tools and gadgets are pouring all over the market. But as usual, the simplest and cheapest ones work like a charm. I used tennis or plastic balls, hard cylinders like shave cream bottles or bottles of ice water (also great to apply some cold at the same time) to roll my foot on. I also bought an amazingly expensive rolling pin (5€) that worked as well as a professional massage one (50€). It's great to massage the legs after long runs!
  • How much: the chapter the better! Don't spend more than a couple euros on a ball or a pin.
  • Where: Sports stores, kitchen stores, your supermarket. Anything hard and rolling could do the trick.
  • When: As often as possible. I used to have a tennis ball at work and roll my foot on it all day long. Now I do it every evening while watching TV. I roll the ice water bottle after my long runs.
  • Remark: Small balls or thin cylinders work the best, as the really dig into the fascia.


4.6 - Supportive slippers

I have the wrong habit of walking barefoot all the time, especially after long runs, which can be very bad for your PF, as mentioned above. However, it can be really unpleasant to wear orthotics are home, especially in the summer. That's why I looked for supportive slippers and stumbled upon the Oofos flip flops. I ordered a pair and I have to admit they the feel pretty amazing, it's like walking on a mattress! The Oofos are a bit expensive but I'm sure other brands and models exists.


  • How much: The Oofos are around 50€, but I managed to get a discount on a pair and paid them only 30€. They are worth every penny!
  • Where: I ordered them on Amazon, as you cannot find them in German stores.
  • When: Wear them every time you are not wearing shoes. Avoid walking barefoot!
  • Remark: They are really soft. I'm not sure they are made for long walks in the city or at the beach, but more for relaxing your feet after long runs.

5 - How I resumed my training

To recall the facts, I got PF in June 2015. I thought at the beginning that a few weeks of rest would be enough to get rid of it. But after some unsuccessful attempts during the summer, when pain rushed back after a few happy kilometers, I resigned myself to put my running shoes in the closet until the end of the year. 6 months total rest, that should do it! Here is how I resumed my training.

5.1 - Phase One / 0 to 21k, complete failure :(

New year 2016 came up with its share of new resolutions and motivating challenges. I decided it was about time to see if 6 months stretching my calves, sleeping with my night splint and rubbing Voltaren on my foot would pay off. To stay tuned and motivated, I started this blog to take notes of my come-back, from PF to the ultra. But I still had a long road ahead of me!

 New shoes, orthopedic sole and k-tape all over me, here comes the Cheeseman, for an amazing run of... 2km?? What, I said I'm taking it easy ;)

 16th January 2016 - It's about time!

For the first three months, I did great, increasing the mileage very slowly, no more than one additional kilometer a week. My foot felt a bit weak, sometimes about to crumble into pieces, but overall ok. I had the impression of running on egg shells or ice, fearing the worst could happen anytime. But it did not. This new year 2016 was full of hopes.

 I did another mistake at the end of March, that ruined all these months of rest and weeks of easy training. Convinced that my recovery would be quick and easy (again, not giving enough credit to the gravity of my injury), I had subscribed to Berlin's 2016 half and full marathons, as a motivation. That's fine actually, I mean why not? The real mistake was to not recognise that I was not ready.

 I pushed a bit my long runs and managed to run 16km the week before the half marathon. But there was still a consistent gap of 5km to cover. Moreover, I got used to run on trails. Concrete roads are less forgiving. I decided to run it anyway and see how far I could go. I posted the details of this misadventure here:

5th April 2016 - Half Marathon Berlin 2016
11th April 2016 - First week of rest

 To sum up, everything went well until km 15, when my foot started to complain. I should have stopped right away, according to the plan, but at the same time I was close to the finish line and I pushed myself to continue. After 18km, streams of pain were rushing now and then into my sole, forcing me to walk. I continued. I finished in 2:30, 45 min after my last PR. A poor performance not worth the price, that I paid the day after. My foot was weak, probably a bit injured and needed some serious rest.

 On the next day, I stupidly ran a few times to catch my subway, one step too much. An unbearable pain stabbed my foot deeply and let me barely able to walk. Well done champ', ready for another 6 months of rest?

5.2 - Recovering from Phase One


This time, it was serious. The pain I felt that day was stronger than anything I had experienced before. My physician was not helping at all, advising me to take drugs and stop running for good. I was getting afraid and I realised for the first time that I might never run again.

 Fortunately, I had the chance to meet a Romanian podiatrist in Bucharest, who did an ultrasound of my foot. The result was indeed alarming: I had an oedema on the deep tissue layers, threatening to damage my plantar fascia even more of it would not resorb rapidly. He booked me for three sessions of cryo-ultrasound, using hot and cold effects on my sole and I felt better instantly. He promised I would be able to run again the week after and gave me some precious advice to keep this plague away from me. They were simple, and yet I had underestimated their importance: less stress, more sleep, keep foot active and the whole leg stretched.

 Sometimes you make mistakes and life helps you get over it. Just remember, don't do the same mistake again!

 For more information about my recovery and therapy, follow this way:
24th May 2016 - 1 month of rest and first therapy

5.3 - Phase Two / 0 to 24k, first success :)

The doc did not lie. The week after I ventured on the trail to try my new shoes... and my new well-rested feet! Everything went well. Although not miraculously solving my PF issue, the therapy did its job, resorbed the oedema and initiated the healing process. Now I had to stay active.

 This second come-back went much faster. In a few weeks, I was able to run more than 10 km pain-free, thanks to a careful routine of stretching, hot-and-cold applications, massaging and healthy running. Summer came, with long and sunny days. I started the Novice 1 marathon training plan from Hal Highdon (see reference section) and naturally pushed the distance, without much effort, quickly recovering between sessions.

 However, as usual, everything did not go as smoothly as planned. My stretching routine was a bit aggressive, which was good for my foot but not for my lower back. Damn body parts all connected! When you pull on one side it breaks on the other :( I hurt my back pretty bad while lifting my byke and I had to take 2 weeks of rest. I used that time to get a complete check up of my back, an IRM and a massage. I also read Paul Ingram's e-book on low back pain and learned a lot about trigger points.

 See this post for more information on addressing my back issues:
31st August 2016 - Back me up!

 After these two weeks of rest, I was back on the trail. Following my training plan as best as possible, running after work and on Sundays, slowly transiting to trail-only routes and avoiding the city's roads, concrete and pavements, I pushed the distance to an encouraging 20km one week before the marathon. This time no hope, no plan, I knew I couldn't finish it and I was going to run for fun, until my foot had enough.

 The Berlin Marathon is an amazing event and I was so happy to participate, especially running with the wife and brother-in-law. Despite of the hard pavement (I was not used to it anymore), I did really great. I had planned to stop around 20km, but actually felt ok and kept the pace until 22km. My foot was getting tired and tense, it was time to stop. I walked another kilometer, then took the train and waited for the wife (a long time!) so we could cross the finish line together. Total: 24km. At ease, soldier, you did great today :)

 Here is my post on the marathon:
26th September 2016 - Berlin Marathon
I felt on this day that I had pushed my foot quite a lot, close to it's "breaking point", but never crossing the line. I used the next days to get some rest, walking slowly and resuming my routine of stretching, massaging and hot-and-cold applications. Everything went well, my first victory on the road to recovery! But I like to remind myself that without the stupid mistake of the half, I might have finish this marathon that day...

5.4 - End of the year and recovering from phase 2

I recovered quickly this time, but did not run a lot up to the end of the year. Between our trip to Chicago (where I ran along the Michigan lake), our Xmas vacations in Romania (where I ran in the snowy Carpathians mountains), the bad weather, days getting shorter and my health not being always at its best, I hardly found the time to get out once a week and my runs were getting shorter. This is by far the hardest time of the year. But my body didn't complain and enjoyed a (well-deserved) quiet end off the year.

5.5 - Phase Three: Aiming at the marathon

"Happy, healthy and reasonable". This is my motto for this brand new year full of hope and exciting challenges. Healthy is still my top priority and I'm reading more than ever on the subject. My PF and my back are not my only concerns. I noticed lately that I've been sick quite often, whereas I was hardly visiting the doc once a year when I was running my first marathon. My immune system is not as efficient as it used to be. Sleep, proteins, vitamins, water? I am lacking something and I want to know what.

 This year is also about debunking some ideas that I took for granted, like "are carbs really the best food choice to fuel my body?". I am planning a few tests, like the MAF (2 weeks with no carbs, see article below) or a 1-month test with more sleep and vitamins supplements. The conclusions of these tests may push me to make drastic changes on my life, to become a more efficient runner and to get rid of my PF for good.

Here's my article and my conclusions: 
6th February 2017 - MAF / The 2 week test

 On the trail side, I feel more motivated than ever! New trail shoes (my first ones) to run safely on mud, snow and technical routes. I'm resuming my training plan (Hal Highdon's Novice 1) a few weeks back to build mileage again. After a few unsuccessful attempts to run on the morning, I'm switching to lunch-break runs, to enjoy the few hours of sun. Everything goes smoothly and I'm catching up quickly where I stopped last year. On the other hand, I cannot commit to four runs in a week, only three, so I organise to get as close as possible to my TP's weekly mileage.

 With deep regrets, I am giving up on the idea to participate to the Eco-Trail de Paris. I won't be ready in less than 3 months to run a 45 km, and I don't wanna attend for less. We'll see next year. However, I'm looking forward to do the Potsdam half, a really nice one I did two years ago, right before getting PF. But this time with the wife :)

 I'm not subscribing to any major race in advance anymore, as I cannot be sure that I will be able to run. But if I manage to follow my training plan, at least the long runs, I should be able to run a marathon in the summer, July or August. That would be amazing. This idea of running a marathon very soon is so exciting.

 On the preventive side, I am less active than last year: I only stretch and apply hot and cold water after my long runs, I do some foam roller on my whole body, especially my back and legs and I wear my orthopaedic sole in my everyday shoes. For the rest, I drink a lot (2 to 3L a day, water and tea) and eat healthy, adding some proteins and good fats to my meals, reducing the carbs.

6 - A few tips to keep it far away

Whether you got PF already or not, your main goal should be to keep this dreadful injury as far away from you as possible. I summarise here what I think are the most important things to keep in mind, for a happy and injury-free running life. Don't underestimate some of them like I did. When PF strikes, it's a bit too late to change your shoes and start stretching!

6.1 - Change your shoes regularly

According to podiatrist and running coaches, you should change your running shoes every 750km, especially if you are running in the city on concrete or hard floor. So don't be cheap or emotional like I was and don't wait for the pain to buy new shoes. Your feet's health depends on it! The best way is to have an old pair and a new one, and alternate them depending on your run (short or long).

 Good running shoes can be quite expensive nowadays (over 100€) so choose them carefully. Usually, I like to read tests in magazines or online, especially looking for models with good arch support and cushioning. Be careful about the drop value (height difference between the hill and the toe sections). I am used to high drops, around 10mm (Asics, Salomon, Adidas), that are less demanding on my calves and better support my arches (since the hill his resting higher). Lower values (4 or 5mm are common, like in the Hokas or Saucony) offer a more natural running experience, close to barefoot running, like our ancestors used to run (or the Tarahumaras still do!). Some brands like Altra are famous for their 0mm-drop shoes (flat soles).

 So choose wisely and don't believe the crazy trendy idea that minimalist or barefoot running will cure your PF (that's exactly what a Runner's Point vendor was assuring me, if I would buy her over-expensive Nike Free...) Although it could strengthen healthy feet and keep PF far away from them, the last thing injured feet need are flat shoes with less support! Any transition to minimalist running should happen progressively and only when your feet are healthy.

 Finally, don't forget that all feet are different, so don't take the tests to seriously, especially what they say about the inside of the shoes (cushioning, support, toe-box room). Try them by yourself! Ideally run a bit with them (some stores like Runner's Point offer a treadmill, other like Decathlon will reimburse you if you are not satisfied over a few month period).

6.2 - Choose your training plan carefully

Don't start anything without a training plan. You can find hundreds of them on the Internet, covering all levels (from overweighted beginner to outrun-a-kenyan level) and all kind of events (half, marathon, ultra). Established by professionals, they are carefully written and take many parameters into account, like maximum distance, rest days, speed work or taper weeks. Choose a training plan suited for your level, not like I did! If you are used to running 20k a week, don't pick one starting with 40km a week! Instead, look for a transition plan. A good training plan should not increase your weekly mileage by more than 10% at a time and offer you a stepped approach: 2 or 3 weeks hard training followed by a rest week with less mileage, before starting hard again.

 Once you decide on a training plan, follow it thoroughly and stick to it until the end. Most of them are flexible, so you can mix up or shift your days of running. However, try to keep the weekly mileage planned and respect the stepped configuration. Don't switch a rest week with another hard one for instance. It is better not to run, than to run too much at a time!

 If you have no idea which training plan to choose, you can start with one from Hal Higdon, a veteran runner with more than 100 marathons under his belt. I followed his TP for my first Marathon (Novice 2) and half marathon (Intermediate 1). I like his careful approach, never asking you to run at your maximum, to keep some energy in the tank and stay fresh and injury-free. More about this in the References section.

 If at any time during your preparation you feel tired, lack of motivation, you have sore muscles and your body does not have time to heal between two sessions, you are most probably overtraining. Take this matter seriously, as all runners are concerned, sooner or later. Google it, you'll see how common it is! So take it easy, get some rest, a few days, a month, a year maybe, if you really need it. You will then resume your training fresh and more motivated than ever.

 As for everything in life, moderation is the key to success. We are not machines and our body needs to rest properly to perform at its best. Therefore plan your runs wisely and you shall stay forever healthy and motivated :)

6.3 - Listen to your body

Your body is strong, but not invincible. Running is probably one of the most basic and easiest sport of all times. We all do it, at some point in our life: to keep in shape, when we play with the kids, to catch the bus, to escape the rain, etc... Everyone knows how to run and recent studies showed that without our ability to run long distances, the human race would be long gone.

Which makes running an underestimated activity, prone to many injuries. When you step on a boxing ring, you know you're up for trouble and you are very careful. But when you go out for a run, are you as well? When you run, you hit the ground and puts about 5 to 8 times your body weight on your hips and knees (i.e. 400 to 650kg for someone like me!), EVERY STEP! This load traumatises your muscles and skeleton. Your body reacts by consolidating itself during resting time, allowing you to run again, longer, harder. But we are not invincible. Hit me hundred times, I'll rise up stronger. Hit me a thousand times and I will break to pieces.

There is no secret formula, no shortcut, no magical way to stay injury-free forever. You need to learn to listen to your body, and it's harder than it sounds! To keep the structure of our bones, muscles and fascia in balance, or body is sending us signals telling us if something is going wrong and if it needs some rest.

Note: The fascia is a the complex network of tissue fibres wrapped around our muscles, which gives elasticity to our body. The plantar fascia (main subject of this page, let's not forget about that) is the part running between the hill and the toes, allowing our feet to re-bounce at every step.

So, long story short, be aware of everything happening in you. Don't believe the old sayings that you need to run through the pain to get stronger. Some muscles cramps, heavy legs, low back stiffness is natural after long runs but an impairing pain in your knee, your foot, your hill (and so on) is a clear sign that's you are done for today and your body needs some rest! 

 I'm not a doctor and I won't develop here all the usual issues runners can go through. There are loads of websites and articles written by professionals on that. Stay aware of the risks and consult your doctor at first signs. Most of all, don't do the same mistake than I did: keeping running and thinking that you are invincible until it's too late. If someday I can travel back in time, I will find myself and kick my butt. Don't make me kick yours too! ;)

6.4 - Get some rest!

As I just said on the previous part, you need to listen carefully to your body, which will let you know when it needs some rest.

Rest is essential to keep the balance between "hurting" yourself while running and recovering from it, stronger and better prepared for your next run. It's not an easy job! If you don't rest enough, you'll get injured like me, but if you rest too much, you will never progress. As usual, the experience of a few years running will teach you a lot about your body and its capacity to recover and you will know exactly how long you need to rest.

Back to my PF problem, I am convinced that I did not rest enough after the 2015 Potsdam half-marathon that I ran at a very fast pace (for me), and that it is one of the reason I injured my foot. A few more days with my shoes in the closet and you may not be reading this blog today (what a shame, eh?). Anyway, what's done is done. But I really take resting and recovering time seriously now. For my body and for my mind!

So, what do I do? First, I make good use of my resting days. Lately, I've been running three times a week (about 40km). Two short runs during the week (usually 10km each) and a long one on weekend (20-30km). I give myself 1 day of rest after a short run and two days after a long one, so my foot can recover completely and my muscles are not sore anymore. I hate running with some pain left, it makes me feel like I'm not ready for another adventure yet. Sometimes, I am particularly tired because of my work or my family life, and I don't feel like going out, so I just skip the day. I don't try to make up for it by running longer the time after that. I don't feel bad or ashamed either! I just see a skipped training like an opportunity to recover some more and be at my best next time.

I cross-train a little sometimes: walking, biking or swimming, although I prefer complete days of rest. Be careful with that and try to keep resting and cross-training days separated. Don't bike 50 km on resting day right after a long run, except if you are used to it! You body deserves a break.

On the nutrition side, I have become more and more aware that carefully planned meals can speed up my recovery greatly. No need to buy expensive power bars for that! I focus on my intake of healthy proteins and fats to repair my muscles: eggs, chicken, lean red meat, nuts, avocado, seeds, milk products, beetroot. But most of all, I drink a lot of water. During my runs, I drink about 1L over 10 to 15km, depending on the heat. After my runs I usually drink between 2 and 3L until the next morning, and I usually wake up thirsty in the middle of the night!

For sore muscles, I like to put cold water on my legs and feet straight after running. When my summer runs gets really hot, I take ice baths (fill up the bathtub with cold water and ice cubes). Finally, I try to massage as often as possible using my foam roller. I noticed that 30 min of it while watching TV makes a new man out of me on the next day! I drink a lot right after to eliminates the toxins (lactic acid) "massaged out" of the sore muscles. Stay away from diuretics (coffee, tea, alcohol) and check your pee: if it's dark, pop up another water bottle!

6.5 - Stay active

When I had my cryotherapy session in Bucharest, the doctor explained to me a simple yet misconceived property of our body: it's capacity to prioritise recovery. We are constantly subject to external aggression, the impacts and vibrations running through our feet when we run is one of many. Like we all do in our daily life, or body cannot take care of everything at the same time and needs to prioritise: whatever is more important should be treated first. The rest can wait! And some tasks will stay on-hold forever.



That's why we need to stay active and exercise regularly. If you go out running three times a week, like I do, your body understands that it is vital for you to run. It adapts and organise to fix you up as quickly as possible before your next run. If one day you hurt yourself, it is well prepared to deal with it and you will recover faster. However, of you go out once a month, your body will take this as a casual activity and consider that there are more urgent problems to solve. If you hurt yourself, you won't recover as fast or as good, which rises the risk of getting really injured.



So don't be a lazy potato and take control of your life! Work on a realistic training plan, offering you enough training to challenge yourself but also enough free time to spend with your friends and family. You will need both to be happy! 

Mens sana in corpore sano  (a healthy mind in a healthy body)

References

I am gathering here some links to websites and references to books that helped me a lot understand PF and recover from it. I am neither advertising nor getting any credit for any of them. I am just thanking their writer here for helping me find a way back to the trail.

Save Yourself from Plantar Fasciitis!
Paul Ingraham
E-book web-page, 20$ (worth every penny)

 Probably the best source of information I could find about PF available on the web. Paul Ingraham is a former massage therapist and science writer, whose speciality is to debunk common ideas on health problems we still know little about. I like his neutral approach on what works and what simply doesn't, based on solid scientific experiments. And top of that, he is a long time PF victim, therefore he knows what he's talking about. 

 I found his e-book a bit depressing at first, I admit, as he was telling me that half of the things I'd been trying out just don't work, and that there was no magic solution working for everyone. But after that, I've been able to concentrate on solutions that show the best results, sparing money and time. A must read you should start with, before following any charlatan's magical solution to cure your PF on 7 and a half day!
Hal Higdon's books and training plans
Books/e-books, free training plans on his web page

 Hal Highdon is a veteran of running with more than 100 marathon to his belt. He wrote many books, like his Marathon ultimate training guide that I strongly recommend to any marathoner wannabe. It won't help you recover from PF, bit it's full of good advice to stay injury-free. 

 But Hal is mostly famous for his worldly known (and completely free) training plans. I followed his Novice 2 three years ago and finished my first marathon in 4:17 with a smile on my face :) The year after that, his Intermediate 1 allowed me to break my half marathon PR (1:45). And I am now following his Marathon Novice 1, hoping to run a second one soon! 

 Hal's plans are built in a way that makes you progress, keeps you challenged, but without asking you to give everything you have. This way you always keep some energy in the tank and you feel fresh and motivated every time you step out. They are flexible and perfect for people like me who are trying to squeeze running between job and family life. I have big hopes that their stepped approach will help me get rid of my PF. 

 Oh, and funny note: Hal is more than 80 years old now but if you contact him on Facebook he'll write you back quickly with some advice! 

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