I went for a trail run yesterday and logged almost two hours through the tall grass, wildflowers, and absurdly steep hills in my back yard. That I’m running at all feels like a miracle. That I woke up this morning with no pain anywhere in my body feels even more like one.
In December 2011, I was skiing down College at Sun Valley at a rather high rate of speed when I caught an edge, tomahawked, and my binding didn’t release. My right tibial plateau shattered into pieces, my fibula broke, and my MCL tore. The five-year journey of recovery since then has been a nightmare of slow progress, setbacks, crazy amounts of titanium screws, ever-present pain, and more surgery—my friends no longer ask how the leg is, ha. But through it all, I have been determined to get back to skiing at a high level and, to my surprise, to something that felt even more important: trail running.
Deep in the middle of this interregnum, 2013, I think it was, I finally got clearance from my trauma orthopedist to start running again, but only on the treadmill. Then I got the green light to ramp it up, still on the treadmill. One day, I ran with what passed for hard effort at the time. The next morning when I got out of bed, my left heel was so sore I could hardly walk. It got better as the day went on, and the next morning repeated the same pattern.
Figuring I’d bruised the bone, I took time off and just rode my bike. But the pain never went away, and when I’d walk or hike it would come roaring back. Maybe it was a stress fracture. I went back to the doc.
His diagnosis was plantar fasciitis, which afflicts about 10 percent of runners. The plantar fascia is a thick band of tissue that connects your heel bone to your toes, and as the “itis” suggests, fasciitis is an inflammation. It can cause severe pain, which typically manifests itself right on the bottom of the heel itself, rather than along the length of the fascia. An easy way to diagnosis it is through the symptoms I experienced: The fascia tightens at night while you sleep, is excruciating when you first start walking, and then loosens and mellows out once you use it.
That’s the conventional thinking, anyway. It turns out this simple explanation of plantar fasciitis is overly simple. One post-mortem study of people who’d suffered from plantar fasciitis showed they didn’t actually have inflammation. Bone spurs may play a role, fallen arches, even tight calves. If that’s the case, what’s causing such gnarly pain—and how do you recover from it?
A WINDING PATH
My journey to pain-free running took me several years, beginning with visits to well-intended medicos who clearly didn’t have the answer. The first doc—every doc, actually—gave me a squishy pad to put in my shoes under both heels. This alleviated the pain slightly, but had no impact on recovery. We tried a cortisone shot (three months of relief, but the pain came back). One doctor suggest eight weeks in a cast with the toes pulled back to stretch the fascia, followed by another eight weeks if that didn’t work. Another suggested surgically cutting the fascia to relieve the strain. Um, no.
The internet, that Horizont Alley of medical advice, had all sorts of suggestions. For months, I slept with the Strassburg sock, which pulls your toes to stretch the fascia. Or tried to sleep, anyway—my foot cramped, the sock got tangled in the sheets, and I had crazy dreams about being in a medieval traction device. I spent a couple months performing a strengthening exercise recommended by the New York Times, claimed as the only routine you need to cure the ailment, but only got chiseled calves and really strong toes out of it. I stretched, I taped, I never went barefoot. I bought a Sharper Image massager and used it twice a day. I rolled my arch over a golf ball while I at my desk. Nothing worked.
By this point, I was a year into it. There had been the delay when I thought time off would cure it, then the bouncing from doctor to doctor, the self remedies, and skeevy internet rabbit holes. A friend’s daughter, who runs track and suffered from PF, found relief from something called Transverse Friction Massage therapy, and I spent $600 over four sessions—subjecting myself to the indignity of paying for the worst noogies I’ve ever had. That only made the pain worse, and it was accompanied by the sharp tang of foolishness.
A SOLUTION AT LAST
Finally, I turned to the deepest source of collective wisdom there is: Amazon customer comments. Yeah, I know. But it was there on Amazon that I found the answer.
The reviewers—maybe bots, maybe sweatshop workers—raved about a product called Heel That Pain Plantar Fasciitis Seats. They cost $25 and look like every other of the 101 bajillion insoles, wedges, and gel pads sold on Amazon, except for one thing—they have a slightly more rigid plug of rubber that sits just in front of your heel, where the fascia connect to the bone. This had the effect—I’m assuming—of supporting, pressuring, and stretching the fascia.
User comments warned of days of pain, as if a massage therapist was working a pressure point without mercy. For me, it didn’t feel that bad—it hurt initially, but the fascia seemed to chill out within a few hours. The next day was slightly uncomfortable, but by two day I didn’t notice it any more. Within a week, 90 percent of the pain was gone. It was as if someone had spun the dial from 11 to 1. After all I’d been through, it seemed nigh on a miracle.
Over the next year, I slipped the inserts into every shoe I wore. I never went anywhere without them. And over time, slowly—very slowly—but surely, the pain went away.
Eventually, I had all the hardware taken out of my leg. It affected my gait and was excruciating inside a ski boot. When the surgical wounds had healed and I was able to walk, I felt like me again for the first time in years—a weaker, older me, but still. For most of 2016, I hiked and hiked and hiked. My knee creaked and swelled from time to time, and the left heel let me know it was there, but only occasionally and it never debilitated me. By fall, I started running—slow, short distances, as low impact as I could. At first, I experienced minor pain in the heel, perhaps from the bone spur that X-rays revealed, but then less so and now never.
So, here we are. It’s been a hella long journey. I’m six years older than when I got hurt, and I wasn’t young then. I was never a fast runner and I’m sure not now. But I don’t care about that–if I can hang on for a couple hours and do it without any pain, other than the expected and deserved muscle soreness, I’m on top of the world. Skiing has been the center of my life for so many years, but trail running feels like life itself.
Will those wedges help your plantar fasciitis? Heck if I know. My personal experience suggests to me that no one really knows whether you have plantar fasciitis or even precisely what it is. Paul Ingraham of Pain Science isn’t a doctor, but he’s right when he says, “Unfortunately, there are so many possible causes of plantar fasciitis — probably several of them happening at the same time — that it is effectively impossible (or just extremely impractical) for therapists to make any confident biomechanical diagnosis. It’s simply too complicated an equation, and the scientific literature is riddled with contradictions.”
That means you have to take responsibility for your ownrecovery, and it probably won’t happen without trial and error. So maybe you can learn from my errors—and one great success. Good luck.
Here’s that link again: HTP Plantar Fasciitis Seats.
Photo by David Marcu
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A terribly painful and persistent condition for many runners. Must be phantom limb pain, my heel throbbed a bit as I read this. Another tip: stay off asphalt. Glad to hear you got some relief. Now, if they could solve atrial flutter…
Atrial flutter is a manageable fix with an Electrophysiologist. I had flutter fixed 10 years ago with no recurrences. Atrial fibrillation is more complicated.
Hi. Thanks for the info. I went to buy the heel cups and saw they come in hard, hybrid and gel so I am confused. WHich ones would you recommend?
The firm rubber ones. Hard.
Great article. I suffered from this for years and while I didn’t go through all the trauma this guy did, I finally ended up using a cheap insert in my shoes. I haven’t had a problem since. Of course, I don’t run as much either, but I am active. I also try to wear good, supportive shoes and boots at all times. In combination with the heel insert, I think that is what fixed me.
Just ordered a set of the “seats”. Thanks for sharing what helped you. I’ll add this to my list of remedies I’ve tried.
Myself (3 times) and assorted friends only got rid of plantar fasciitis for good by keeping it stretched overnight so it didn’t rip again with that fisrt step with weight in the morning. I took the liner out of my alpine ski boot, tied a dish towel loosely around the top, and slept like that for three or 4 nights. PF gone…
Rolling a golf ball helped, but the ski boot liner was magic.
Sounds crazy but it was $400 cheaper than the splint they wanted me to buy.
You got a picture of that construction?
Man, that’s a journey. Glad to hear you found something that worked.
Not sure how you maintained sanity thru all of it. I’m out of action for a relatively short while (ruptured achilles), and my lovely wife is taking the brunt of it.
That’s one fugly x-ray. I know we’ve seen it before, and it’s still ugly.
After you felt no pain…did you continue to wear the wedges? Do you wear them now?
I’m going to try these, but I can’t help worrying that this is just another clever advert. I’ve tried so many cures for my plantar, still no relief. I can’t run, and running is my anti depressant. Praying that I’ve found a cure in this, if you really are genuine thank you. If you’re not, you’re a bad person.
Really? Please.
What do mean “Please”?! That was a valid comment.
I’ve been dealing with PF for 9 months. I’ll try them for $25. I’ve tried just about everything as well. I want to play basketball again! Yeah I’m 60 and old and slow but it’s the only running I get. If you want an old car to the keep running, better run it every day.
This was THE BEST tutorial ever! Thank you so much & I will be sharing this with everyone I know!
I’ve had these heals for 3 months and they didn’t work for me. They helped get me throught the day, but after 7 months my PF has not improved at all.
Steve, what is your take on Nancy’s comment, please?
I’m sorry they didn’t work for her, but as I said, you’re going to have to be your own advocate here until you find what works. Perhaps there’s something else going on, like a bone spur, but unfortunately, Nancy’s going to have to keep looking for a solution.
Eager to try this, I am clicking on the link now. This condition is new for me, and I don’t want to put up with it for a year plus. I swim as well as walk, not run; but today I couldnt even walk from the parking lot to the pool without excruciating pain.
I think I will try the above mentioned ski boot insert at night and the Amazon insert during the day. Thanks for your long, painful, but happy ending story.
Thanks, Sue—let us know how it goes. I had a friend try the Amazon inserts based on my experience and they worked for her. Would love to hear whether and how they work for you.
Do you have a follow-up for all of us, Sue?
Here’s goes a shot. I’m a nurse and this pain makes it so hard to get through the day.
Two years later, I’m still pain-free. And I actually stopped using the inserts a while ago.
Which inserts u used .. Please reply
I wanted to personally thank you for writing this post. I bought the inserts a month ago, they are the first thing I try that’s doing something to cure my PF (not alleviate it), after two years. The sharp focalized pain, typical of PF, is almost gone. There’s still pain, but it’s milder, and it feels like it has spread out to the whole heel and the Achilles tendon. Which means that there’s a structural biomechanical thing going on my left foot. It’s funny, on the right foot (no PF) I don’t even sense the insert anymore. A combination of these thingies, good shoes, and doing all those things I used to do with almost no outcome (stretching and icing, mainly) has made a huge difference. I’ll come back in some months to give an update. May karma be good to you, Steve.
Amazon don’t ship to Belgium this product. Any idea how can i get my hands on these? The pain is annoying…Thanks man, Klara
I just wanted to stop back at this article and say…Thank You Steve. I really mean it…thank you. I googled “I’ve dealt with plantar for 2 years” and this was the top search result…I reluctantly ordered the inserts (I had tried a few inserts before without much success). After about 10 days of gradual improvement, I woke up a few mornings ago and walked to the bathroom normally…it hit me about 5 minutes later that I didn’t feel any pain and I didn’t limp at all! I also had been wearing a foot brace daily for 2 years now…I finally eschewed them yesterday, as I’m now feeling 100%. I wish I would have found this site earlier. I thought I was going to deal with this problem forever. Even my doctor said “This is a lifelong injury”…pfft! So, again, Steve…my many thanks. You improved the happiness level of my life! JD.
Yay! So happy to hear that!
Ive had plantar faciitis for almost a year now, I am going to order those now, I have done everything things else, massage, foot soaks, compression socks, cupping, and everything you did as well. I am going to go buy those, I have already spent thousands, I truly hope this works, if it does I will report back here!
Ready to buy Frozen Shoulder and Plantar Fasciitis books. Lost the order page/link. Please send. Thank you.
Thanks for the write-up. Do you need to wear these long-term, or do they heal your PF so you can be pain-free without them?
It healed mine completely. I can’t recall how long it took but it was probably 2-4 months. I never thought I’d be pain free again and now it doesn’t even enter my mind. When I take long walks or hikes, I still put them in my shoes still today, but its for preventative maintenance/peace of mind. I really don’t need them but I don’t want a re-occurrence. A couple times I went on hikes without them and my foot felt slightly fatigued afterward…and I don’t get that when I use the insert…so I throw them in from time to time still. Buy them, it’s really worth it. JD
This was really helpful. Like so many another’s I have had PF since quarantine. I am active so I still workout in the morning mostly sculpting ( jumping, lunges, weights, jumping jacks) and I do this barefoot on a soft mat. When you first used the inserts did you still exercise like normal?
Well I was never much for exercise! 🙂 I am active on a disc golf course and I walk a few miles each day after work, so I get a lot of steps in, but not much running. So I just wore them whenever I wore shoes, work or otherwise, and that seemed to do the trick. I’d say just walk a lot on the inserts for a few weeks and stop running or doing anything barefoot until you feel near 100%. It won’t take long, maybe 2-4 weeks I bet. If you insist on working out in the interim, I’d wear them while working out, yes.
Please be sure you have the right diagnosis. Could be fat pad atrophy. You can walk out of bed with no arch pain. All pain in heel. No surgery options. PRP may not help.
Steve,
I want to thank you for taking the time to share something that worked for you, I realize it may not work for me and perhaps some of the others who have read your article, but it worked for you and others who tried your method. I’m 68 and very active and dealing with this for the first time in my life, I’m going to try it and hope for the best. My point is, you are to be commended for trying to help others that are seeking a solution to their malady, and that is commendable, thanks again.
You may not want to hear this, but you probably did not have PF. It’s not uncommon for doctors to hear “heel pain” and to assume it’s PF. The usual treatment begins and soon a month, 6 months, a year has gone by with little improvement. That’s because the treatment for PF (stretching, night splints, dumb socks) is contraindicated for the other conditions that can cause similar symptoms! Imagine having a sprained ankle and the treatment is to keep spraining it….
plantar fasciitis is a condition that causes heel pain bottom side of the foot. plantar fasciitis is a tissue band that connects your heel to the balls of your feet. it’s a normal foot disorder you can recover from it soon. First I suggest, take proper medical treatment from a professional podiatrist doctor can give you the suitable treatment as problem severity, if you are searching for the best heel pain doctor in NYC you can schedule an appointment with a professional podiatrist Dr. Neil Zwiebel. rest you can use some tips like light exercise, complete rest, and slow stretching.
I tried the night boots (splints) and they worked, but they were so uncomfortable and clumsy. Then it occurred to me that a pair of crocs with a backstrap would hold my feet in the same 90 degree position, and they do. The crocs immediately did the trick. No more pain. I sleep in them every night.