Winter Running

If you suffer from sore feet, be careful where you walk and run: with a few bad steps, dangerous surfaces can injure you and undo weeks of recuperation.

Icy, snowy areas represent the most evident example of a dangerous surface. With your feet slipping, sliding, gliding, and floating unpredictably in any direction, icy surfaces can inflict extra damage to your already tender feet and/or Achilles tendons. And on those flat icy areas with ice and snow chunks frozen in place, walking and running can be horrific. Don’t attempt to navigate ice-covered areas unless you absolutely have to.

Moving across any type of uneven surface will be questionable to the safety of your feet. Luckily, walking or running through such an area will feel uncomfortable, and you’d probably sense right away that it’s not good for your lower extremities. And you’d be right. The foot in the lower position is subject to undue stress, as it carries an excessive proportion of the load in this situation. The discomfort should stop you from settling into a route or area that features this type of footing and repeating it as your regular routine; note, however, that even one pass through a risky, icy area can re-injure vulnerable feet. Be careful where you travel.

Some ideas to handle navigation on icy, snowy, wintery conditions:

- Choose relatively even surfaces if you can.
- Use restraint and caution when exercising upon icy, snowy surfaces; assume that all wet, dark areas on pavements are slippery.
- Choose footwear that provides traction; shoes or boots with soles that are grooved, vs. smooth, are ideal.
- Walk and run with a short stride, keeping your center of gravity directly over your feet as much as possible. Avoid the aggressive, lunging stride. If you do this on snowy, icy surfaces, you won’t be walking or running long anyway. You’ll most likely be twirling around on the ground.
- Consider ice-gripping devices for your footwear, like YakTrax or Ice Grips; the metal “teeth” on these accessories can really bite into snow and ice, and keep you from slipping and tumbling.

During the winter in a snowy area, it’s great to keep active, but at the same time, keep safe!

I happened upon a couple of articles on Eli’s injury, and read them with interest, since his condition is the topic of my book Injury Afoot. Sure enough, just a few sentences into one of the stories, a doctor interviewed for the piece mentions injections of corticosteroid, often called cortisone, as one of the top treatment options. I cringed. Horror stories abound regarding heel pain sufferers turning to cortisone injections and experiencing side effects that make plantar fasciitis look quite tame. Yet some in the medical field keep recommending these injections. Yikes.

I’m sure Eli has a team of therapists and trainers working with him on active recovery methods such as icing, stretching and strengthening. Active recovery is what you want Eli; steer clear of the cortisone injections.

Patrick Hafner, Author, Injury Afoot: 30 Things You Can Do To Relieve Heel Pain And Speed Healing of Plantar Fasciitis.

My thoughts: for the most reliable, long-lasting recuperation from plantar fasciitis, a person should stretch, strengthen, brace, and accommodate – don’t medicate.

But regarding stretching, as with most things, there is advice. Then there is questionable advice. And then there is insane advice. Case in point:

Floating about the plantar fasciitis rehab community is one very risky, aggressive, and hazardous stretching technique. It goes as follows: stand on a step, curb, or ledge of some kind, putting your weight on the ball of the foot to be stretched (Fig. 1).

Figure 1

Then, the advisors of this stretch say, lower that heel way down, letting all of your bodyweight pile on to stretch out your calf area. This is to be done on one already tender, injured foot…with your full body weight. (I couldn’t bring myself to fully demonstrate this tactic in Figure 2; I kept a little weight on my front foot to avoid a painful re-tearing. Most instances where this is recommended, however, the “expert” instructs the person to stand fully on the injured foot. Ouch!)

My oh my. I can almost feel the vulnerable tissue give way a little more, exacerbating the injury further. Nice. A forceful, brutal, impatient stretch like this is the last thing you want to do when you are recovering from plantar fasciitis. A plantar fasciitis recovery routine should be more like walking on eggshells, vs. squashing grapes into wine, if you catch my drift. Do not do the stretch as detailed above.

Figure 2

Let’s try a similar and much safer version of this stretch. As demonstrated in Fig. 3, standing next to the step or curb, place the ball of your foot to be stretched against it. Keep most of your weight on your supporting leg, not the leg to be stretched. This allows you to control the intensity of the stretch, and carry it out as all stretches should be carried out: gently.

Proceed to…

Figure 3

…lean ever so slowly into the stretch. Hold it at the point the stretch first starts, not beyond that point (Fig. 4). Hold it 15-20 seconds. Repeat this process once  or twice. Do this twice a day. You’ll realize an effective stretch which you can control, which can be done almost anywhere, and which causes you no further harm.

For a complete rundown of effective stretching and strengthening actions sure to help rid you of heel pain caused by plantar fasciitis, take a look at the book Injury Afoot: 30 Things You Can Do To Relieve Heel Pain And Speed Healing of Plantar Fasciitis. The steps detailed there are safe, can be done at home free of charge, and they work.

Figure 4

But that opinion could be influenced by the order in which I had the two conditions. I acquired plantar fasciitis first. It was pretty much healed up once I felt the Achilles tendonitis symptoms creep in – a nagging soreness and tightness in the band of tissue which attaches at the heel and travels upward into the calf region, often called the heel cord. And being a veteran plantar fasciitis sufferer, I knew what to do immediately: back off. I stretched the area a little more than I had been, but other than that, my course of action was to ease off on the things that were causing it, mainly uphill sprinting in this case. I had not been doing much of that type of training, and after deciding to embark on it regularly, I went ahead and overdid it. Going from zero to full-tilt will almost always have deleterious effects, regardless of the activity. Sound familiar?

So my particular case of Achilles tendonitis healed in short order, thanks to NOT doing what I did upon first feeling plantar fasciitis’ soreness approaching: keep doing the same thing and hoping it would disappear. It doesn’t work, trust me.

So what if you acquire Achilles tendonitis, and keep on keeping on with whatever is aggravating it? Well, if you make that choice, the initial soreness is going to end up feeling pretty mild compared to what may be awaiting you. Continuing with the straining activity, be it training on risky surfaces, activities with plenty of jumps or stops and starts, uphill walking, walking or hiking longer than you’re prepared for, etc. may in fact result in a rupture of the Achilles tendon…yes, a complete tearing of the tissue. Often the procedure to rectify it at that point is surgical reattachment. Ouch.

Sound worth the risk of continuing on with the aggravation? I don’t think so. I’m glad I made the right choice and readjusted my activities to accommodate the blossoming Achilles injury. You should do the same, if you sense Achilles tendonitis may be starting. And remember, prevention is always easier than a cure. To see a description of stretching and strengthening motions which will head off both plantar fasciitis and Achilles tendonitis, take a look at my book Injury Afoot: 30 Things You Can Do To Relieve Heel Pain And Speed Healing of Plantar Fasciitis. The exercises are compiled into one brief, easy-to-read source.  They’re easy, they work, and they don’t take long to learn or do.

The plantar fasciitis condition is one which results from long-term, repeated wear and tear where you accumulate micro-injuries. In other words, cumulative damage. Not sounding too beautiful so far. So, what’s my point?

My point is, you have a fair amount of leeway when experimenting with recovery methods and the altering of your routine as you allow your feet to recover and heal. It’s hard to recuperate from plantar fasciitis while being largely inactive. Conversely, it will be far more beneficial to you and your feet if you are active, engaging regularly in strengthening, stretching, and endurance-building motions. But…you can’t overdo it either. And that’s where the beauty of cumulative damage comes in. You actually can do some trial and error, push your limits here and there, and ease back on efforts which prove to be too much. It took a long time to get to the injured state called plantar fasciitis; the body will adjust if you do a little too much now and then according to your individual physical makeup and injury severity. For example, you won’t undo months of recovery if you applied too much enthusiasm to one extra long walk or one arch strengthening session. Back off, let the soreness recede, and do a little less the next time. Make your recovery journey a learning experience as well as a comeback to a healthy state. When it comes to active recovery, proceed with confidence, not fear. Adjust as you go.

For a complete listing and description of every stretching and strengthening motion you will ever need to vanquish plantar fasciitis, consider my book Injury Afoot: 30 Things You Can Do To Relieve Heel Pain And Speed Healing of Plantar Fasciitis. The exercises are easy, painless, don’t take long, and can actually be relaxing. They are all consolidated into one brief, easy-to-read resource.  And they work.

The opposite extreme is high heeled shoes, meaning anything from stilettos to cowboy boots. High heels jack the back of your foot way up, and in addition to providing little support, contribute to a shortening in your calf region and Achilles tendon. This is bad news if you already suffer from plantar fasciitis, and will increase the odds of acquiring it immensely if you don’t.

For a full description of what to look for in footwear, you may want to check out my book Injury Afoot: 30 Things You Can Do to Relieve Heel Pain and Speed Healing of Plantar Fasciitis. But in short, avoid flip flops and high heels as one more step in conquering and staving off plantar fasciitis.

I love that quote. There’s simplicity in it but also plenty of power.  As you proceed with a plantar fasciitis recuperation campaign, you will need to pave the way, set yourself up for success, whatever cliche you want to use; your body will heal itself if the best possible environment is created in which to do so. So do whatever it takes to make this happen. Alter your behavior to avoid foot-aggravating activities; commit to your healing effort. Don’t skip strengthening and stretching sessions; don’t panic and give in to despair. Stay positive and stay on track. As you learn more about plantar fasciitis healing from the discussions here, just keep in mind the overriding theme of active recovery: the body can and will heal itself. You just have to promote healing and let it happen.

A Word About Stretching

No absolute verdict has ever been reached on the very best method with which to stretch muscles of the human body. If a person researched the topic until locating 100 articles or books on stretching, I think that person would find some glaring discrepancies. Probably 30 or 50 or 70 different takes on the number of repetitions, length of time to hold a stretch, stretching a cold muscle vs. a warmed-up muscle, and how far to stretch an inflexible muscle would appear. Overwhelming agreement amongst the experts on stretching does not seem to exist.

I don’t have the final answer on stretching, but I know a couple of things:
- Stretching can help you recover from plantar fasciitis, and
- Stretching can injure you.

Over the years, I got into the bad habit of never stretching. My best guess is that this lack of stretching helped me acquire plantar fasciitis in the first place. But once I started stretching on a regular basis, the healing process accelerated. I mean, really accelerated. The healing seemed to take place several times faster. And on walks and hikes where the soreness would recur, taking the time to stretch again would usually reduce the pain or make it go away completely. Stretching is a good thing, and most experts on the subject agree that it is not only helpful but imperative to stretch to resolve a case of plantar fasciitis.

But if you stretch a muscle with too much force and in too much of a hurry, the muscle can tear. And your injury problem will then become compounded. So keep three words in mind for a successful stretching venture: Consistent. Patient. Gentle.

Stretch regularly, at least once a day, as you help yourself heal from plantar fasciitis. A few times a week will not be enough. And try not to hurry. You must hold a stretch for it to work, and you might find yourself becoming a bit bored. Practice patience. And above all, be gentle when stretching. If it hurts, back off. If a stretch goes no further without discomfort, don’t force the stretch past that point. Ever. Be gentle and you won’t injure yourself while stretching.

How long should you hold a stretch? Over the years I’ve heard figures from two seconds all the way up to sixty seconds, and a wide variety within that range. Basically, they’ve all worked for me. As long as I did the stretches in the first place, and didn’t get too rough while doing them. I’ve listed the very general estimate in this book of holding a stretch 15-20 seconds, then repeating that stretch three or four times. Why? It’s worked for me. If you find holding a stretch shorter or longer than 15-20 seconds works better, then do it that way. Experiment and find the best duration of stretching for you personally. Just remember to be consistent, patient, and gentle, and your stretching endeavor will be effective.

You may also develop “heel spurs” as a result of the plantar fasciitis. Heel spurs are calcium deposits which result from the inflamed plantar fascia being pulled and strained where it attaches to the heel. The heel spurs form at the front of the heel and can be felt through palpitation. Heel spurs themselves do not hurt, and do not cause plantar fasciitis. They are instead a symptom of it.