marcoviappiani wrote:
I have been through PF twice and it was coming from under the heel. I tried a lot of stuff so it's difficult to say precisely what worked and what didn't.
What I think was particularly useful for me was:
- Rest. If in the acute phase maybe worth not running for a while. Then getting back into running very slowly with walk/run progressively increasing the run proportion. I didn't know what it was and could run through the discomfort (also, it would seem to ease after warmup) so I kept running for way longer than I should have, especially the first time it happened, and made it worse.
- Exercises given by the phisio, but especially calf raises and exercises to strengthen toes and foot balance.
- General weekly mobility/hip and core strength also help.
- Insoles with higher arch. I have custom insoles in my main running shoes and in my main cycling shoes. I also have non-custom insoles in my other running/cycling shoes and non-sport shoes. I can't really tell if there truly is benefit in the custom ones vs mass produced ones with higher arches.
- Replacing old shoes (especially running/walking shoes with lots of mileage one) and in general uncomfortable shoes.
- I make sure most of the footwear I use has a bit of arch support (I have the Hoka slides for home and the Hoke filp for beach/swimming pool). This is especially important if working a lot from home. For me this was night and day vs standard slippers or flip flops.
I did some shockwave therapy at the physio, I can't really tell if it did anything.
I'd say it's better to go to the physio rather than relying just on internet advice (but I tried 2 or 3 of them). I found one physio (out of the two or three I visited) in particular recommended exercises that were particularly suited for me as he noticed I had the affected leg weaker than the other, and a lazy big toe.
I found pain medicines (voltaren, pain killers) made absolutely no difference for me.
I have no scientific proof to provide but I think all in all what worked for me is the exercises and insoles.
An occasional use of shoes without insoles (say Vaporflies on triathlon race day) doesn't seem to be a problem now.
Yep. All of this. I suffered from PF and related symptoms for a long time. Mobility and stability of the entire lower body is critical to long term recovery.
I will add that rigid (specifically) custom insoles can ultimately make the problem worse. Flexible insoles that support the arch but allow the foot to flex normally are the way to go. I've had full rigid, custom hand made foam, and now commercial molded inserts. The full rigid worked for a while, but ultimately cause weakness in the foot, and put stress in other parts of the foot which caused problems that took a very long time to resolve.
I currently use Upstep insoles. I switched when my hand built custom foam insoles finally died. I've been super happy with them. It's an online ordering process, and they ship you a foam mould for you to step on. Then they ship you your inserts In couple weeks. Adaptation to the new inserts was quick and easy. I wear them all day, every day. I have two sets, one for daily shoes and one for running shoes.
The other thing I would add is calf stretches--- both straight leg, and bent leg. I prefer to do both legs together rather than one at a time. This is to prevent overstretching, and causing more pain---especially, while in the throughs of active PF. But, it's also just a little more time efficient. Remember that you need a total of 90+ seconds of stretch per muscle in order to make significant progress in flexability, and a minimum of 30 seconds per stretch. Could be 3x30s, 2x45s, or 1x90s...but not 9x10s. Also, stretches should be done in shoes with the insoles installed.
I agree with the ALWAYS WALK IN SHOES WITH SUPPORT advice. Since making a full recovery, I do violate this rule. And, I wonder if there is some benefit to increasing tolerance for barefootedness, but I have no data other than my own experience. It has not caused any issues for me, and I've been PF free for 9ish years now.
I did Shockwave also, and it did nothing GOOD. It caused a lot of pain, and took weeks to recover from.... With no improvement after recovery.