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Wednesday, 14 August 2013

Recovering from Plantar fasciitis

Plantar fasciitis is a pain in the heel that is typically worst first thing in the morning. This is my story of continuing recovery. I am not medically qualified and if you suspect you have Plantar fasciitis, get a doctor or physiotherapist to check and follow their advice.

For standard information, try this Wikipedia article and for evidence-based advice, try the National Institute for Health and Care Excellence article

So, I "caught" Plantar fasciitis at the Chippenham Folk Festival at the end of May. I did a lot of vigorous ceilidh dancing mainly on a "wood" floor that probably had concrete a few mm down. By the time I got home, walking was extremely painful. I had already booked for two festivals in August so I needed to fix things fast. I have largely succeeded. Here's what I tried, my thinking and observations:

  1. I stopped walking 4km a day to work and drove. In fact I became a total couch potato.This was intended to reduce further damage and pain
  2. I bought into the theory that a contributing factor is an Achilles Tendon that's too tight which keeps the Plantar fascia too tight and did exercises to stretch it as per the NIHCE article.
  3. To protect the Plantar fascia, I used gel pads in my shoes
  4. I avoided walking barefoot
  5. I visited a physiotherapist. My choice was a local clinic that offered the minimum number of unproven trendy treatments. (I couldn't find anybody who didn't offer at least one bit of quackery!). The practitioner I saw seemed to share my love of evidence-based medicine and her knowledge of what did/didn't/might work matched my own reading. Perhaps the most important question I asked was: if I took pain killers, could I end up doing more damage? Her answer was basically "No" and that if I was doing damage, no analgesic I could buy would stop the pain.
  6. Based on this, I got in a supply of the strongest paracetamol and codeine tablets you can buy in the UK without a prescription. If I experienced pain when dancing, I took one plain paracetamol and if the pain persisted, I took one paracetamol/codeine mix. 
  7. The above drug routine was largely successful although there were some surprises:
  • In 7 nights, I only needed to get up to the full dose three times.
  • The affects of two months of virtual inactivity showed. I was often stopped by other pains and shortage of breath
It seems likely to me that a lot of the dancing (which was on floors with a reasonable amount of spring) was usefully exercising the other muscles near that heel. I was also modifying my technique to avoid banging the heel on the floor. I fully expected some of the vigorous rant steps and hop steps to give me instant agony or trouble next morning but they didn't.

So I very tentatively suggest the following regime to Plantar fasciitis sufferers:
  • Protect the heel against impact
  • Exercise all the surrounding parts pretty vigorously
  • Don't be afraid to use any pain killer that's otherwise safe for you.
Remember: I'm not a doctor!

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