Tag Archives: plantar fasciitis

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Shamrock Run, Portland, March 2018

Shamrock Run, Portland, March 2018

I was never a serious runner. At least, I was never as serious as club runners, or marathon runners, or even friends of mine, who are both marathon and club runners (and have the times to prove it).

Instead I am a slogger. At my peak, and the peak of my cartilage, I was managing about 60k a week, running home from Dublin city center to our Raheny apartment five days a week. I never monitored my times, I just ground it out, day in, day out, along the Clontarf Road. In the years before that, I’d do the same around the Phoenix Park.

Then the injuries started. The plantar fasciitis first, followed by the diagnosis of hallux limitus, which became hallux rigidus, all of which I’ve blogged about previously. I kept running, but ran less and moved my workouts to a stationary bike. It wasn’t the same, but at least I could read and listen to music.

As time passed, the runs lessened and the bike work increased. By the start of this year I was shuffling through 5-10k a week, and feeling a long way off the pavement-pounder that I used to be.

This wasn’t helped by a visit to a podiatrist last year, who confirmed my worst fear – that the arthritis in my left big toe needed surgery and the sooner, the better. This has yet to happen, and managing the pain was the single reason for the fall off in my running.

Until last month. On a whim I joined a group of Nike colleagues who’d signed up to run the 5k Shamrock Run in downtown Portland. This mean training, and training meant a return to running. Over the course of February I moved from 5k to 30k, pushing my time down and spending a lot of rest time with an ice pack.

Last Sunday I ran the 5k, pulling in a not-bad time (despite the strollers – baby and human). It was enjoyable on the day, but the prep was even more so. For the first time in a couple of years, I’d accessed that clean, good feeling that – despite the foot pain and the burning chest and the rain and the traffic – reminded me of why I’d often ran 50k a week without blinking.

Over the years I’ve hiked, swum, walked, and cycled, but nothing matches the sweat-soaked, mind-clearing experience that comes of stepping out the front door and going for it. Even if my times aren’t anywhere near the old days.

What’s more, my foot’s holding up. For now.

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The running advice that keeps me on track

Haruki Murakami

Haruki Murakami

One of the best insights I’ve encountered about running came not from a coach, or a sub-three hour marathon runner, or an athlete interviewed with a new medal.

Instead it came from a (then) 56-year-old man who I’d never met, and who’d made his name writing stories about – among other things – talking cats and alternate realities accessed through wells.

When Haruki Murkami wasn’t dreaming up his postmodern fables, he spent a lot of time running. And a lot of that time was spent running marathons (Murakami’s tackled the Boston Marathon six times).

His experiences led to his 2007 book What I Talk About When I Talk About Running, a memoir which recounts how the Murakami-the-writer became Murakami-the-writer-and-obsessive-runner.

In his mid-50s at the time, Murakami was familiar with the highs all runners know. Given his age, and the strain marathons place on joints approaching their sixth decade, he knew the lows too, the tough days on the track.

“Pain is inevitable. Suffering is optional…The hurt part is an unavoidable reality, but whether or not you can stand any more is up to the runner himself,” Murakami writes.

When you’re running well – in my case 75% of the time – such thoughts never cross your mind.  But Murakami’s advice has become a critical mantra to get me through the hard sessions, the mornings when my plantar faciitis kicks off, or my shins begin to splint, or I simply find myself slogging through 45 minutes of steady wind and rain.

And pulling through those sessions is, to me, what the spirit of running is all about.

Dawn run, Galway, 2015

Dawn run, Galway, 2015

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The five stages of runner’s grief

The foot

The foot

“The waiting is the hardest part,” sang Tom Petty in his 1981 hit, a song written as he recovered from a hand injury which limited his guitar playing. Or so I once heard.

At least Petty got back to the fretboard. My own experience with injury of late has been more along the lines of The Long and Winding Road, most of which has been pedalled.

For the past three years I’ve suffered with a running injury that worsened from an annoying niggle to a painful case of plantar fasciitis to a diagnosis of osteoarthritis in my big toe.

The result has witnessed a collapse in my mileage, from around 50k a week in 2013 to a pitiful five (10 if I push it) at present.

A programme of physiotherapy, along with exercises, x-rays and shoe inserts, was followed by a medical consultation and, finally, an appointment to an orthopaedic surgeon next month. While I wait on the latter my exercise regime has been confined to static, dull hours on a stationary bike, broken up by long walks (tantilisingly along my old running route).

The ongoing big toe saga also led me to google ‘how to cope with running injuries’, which brought me in turn to a Runner’s World article documenting five stages of ‘runner’s grief’.

First off, I’m aware that there are bigger problems in the world that a painful toe. But anyone who’s been injured will have encountered one or more of the five stages – denial, anger, bargaining, depression and – the fabled holy grail – acceptance.

Run or walk? Jogging in Porto, 2015

Run or walk? Jogging in Porto, 2015

In my case the first two, denial and anger, were one and the same, signifiers of a period when I’d run 40 and 50 kilometres and then lose my temper when I could barely walk for three days afterwards. Being as stubborn as most runners, this pattern of jog-wobble-hobble repeated itself for a year.

Then, with the onset of physiotherapy, I shifted to the third stage. I’d trade a dull, 45 minutes on the exercise bike for a 5k run. Then it became an hour for 2.5k and a handful of Vitamin I.

Was I depressed at this point? If I was I buried it in sweat and episodes of Deadliest Catch – still my stationary bike show of choice, mainly because the Bering Sea looks like the only place less enjoyable thank the tedious pedalzone I set up in our living room.

Then, one afternoon last December I walked into a radiology department at a Dublin hospital and, at long last and by way of my doctor, received a diagnosis. And now I’m awaiting the surgeon’s appointment.

Cue acceptance.

But not so fast (a bit like my 5k times). While I convince myself that I’m at ease with my injury and assure myself that I’ve learned lessons of limitation, ageing and common sense, the first question I’ll pleadingly ask the surgeon will be “can you help me run 50k a week again?”

To which he’ll likely laugh – and then recommend a stationary bike. Petty was wrong. The waiting’s been easy – the accepting’s the hard part.
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How it took me 93 days to run 10k

Back on track.

Back on track.

THE REALISATION came 40 minutes in, just after the service station and before the yelping terrier.

After 93 days of pain, rest, stretching, rolling, cursing and – slowly, slowly – running again it struck me: I was going to complete the 10k.

Thirteen weeks after I limped into my physiotherapist’s clinic I was finally back to my regular running distance.

I’ve written before on how I was injured. A sprained toe broke the camel’s back of my bad habit of not stretching, which kicked off plantar fasciitis (PT) in both feet.

I was ordered off running and onto foam rolling, with a shot of dry needling thrown in for a bit of variety.

In the weeks after I moved from walks to 5k jogs to 7.5k runs. I even hiked Lugnaquilla on a 13k loop.

But, until last Saturday I hadn’t attempted my usual distance in a run.

The final couple of kilometres weren’t easy, and running half the route on concrete was foolhardy, but I made it over the line.

Initially I felt good. Twenty-fours hours later darts of pain through my soles warned me not to overdo it.

That’s the odd thing about this habit. I spent the summer recovering and re-training to reach a position where I could easily injure myself again.

The plantar fascia, on the sole of the foot. Pic: Gray's Anatomy of the Human Body

The plantar fascia, on the sole of the foot. PT causes it to swell.
Pic: Gray’s Anatomy of the Human Body

Strangely, the risk of another serious injury doesn’t bother me like I thought it would. Perhaps the hours of stretching, glute lifts and other tedious exercises have finally taught me patience.

But there’s something else.

As I’ve gotten older the spectre of pain has loomed larger in physical exercise, be it running or hiking.

If it’s not to the fore it’s always out there somewhere, 10 or 50 or 100k down the road, at the bottom of the next hill.

When I first blogged on my injury back in May my friend C wrote to me, observing that many runners, as they age, appear to be hooked on battling pain.

This is somewhat true, I think. My youthful 20s are a distant memory and I’ve now factored discomfort into my running routine; it’s another element, like weather or time of day.

Writer Haruki Murakami, in his running memoir, recounts advice he once came across in an interview with a successful marathon competitor. “Pain is inevitable. Suffering is optional…The hurt part is an unavoidable reality, but whether or not you can stand any more is up to the runner himself”.*

Good advice, but still I didn’t repeat last weekend’s 10k the following day. Not wanting to take a chance with pain, or suffering, I jogged out a cautious 7.5k.

I’m still not fully recovered. But I have that fresh 10k in my back pocket.

That’ll do – for now.

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*Haruki Murakami, What I Talk About When I Talk About Running (Vintage, 2009), p vii

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Sprains cost. And you start paying…in sweat

A grand stretch in the mornings.

A grand stretch in the mornings.
Pic: Clare Kleinedler

I don’t listen to Joni Mitchell when I’m running.

Her light-as-air voice and folk-jazz stylings jar with the lung-exploding, grunting, existential trauma that characterises my regular circuit.

But if I did I might have paid attention to her Big Yellow Taxi warning: we don’t know what we’ve got ‘til it’s gone. I certainly should have in the lead-up to a recent injury.

Neglecting to listen to my body (until, eventually, it grabbed me by the collar, shrieking in pain) saw me out of running shoes and onto the physiotherapist’s bench. It also introduced me to cruel, unusual and wholly necessary punishment of foam rolling. More of that below.

The background to all this goes back three years to a New York Times’ article I read on the pointlessness of stretching before a run. My mistake was extending this advice to after my run too.

The result was chalking up five 10km runs a week with minimal (read: zero) warm-down stretching. Maybe a dozen times in three years, and just hams and calves to boot.

The eventual outcome of this should have been apparent in advance – not least when I found myself crawling off the table in agony after a couple of leg massage sessions last year.

But no. I jogged on and on, approaching the painful reckoning one 10k at a time. It eventually occurred when I stubbed my toe on a crack in a concrete pavement in early May.

That was painful, but still not enough of a wake-up call. So for two weeks I continued to run on a big toe which, I later discovered, was sprained.

A day after I blogged about my injury I attended my physiotherapist who, deftly masking her horror at the condition of my feet and legs, ordered me off running for a month.

Like a pulling a piece of muscular string the toe sprain had kicked off plantar fascisitis (swelling of tendon on the sole of the foot) in both feet, strained my peroneal muscles (on either side of the shin) and my vastus medialis (the muscles above the knee).

My gait had wrenched my overworked muscles so tight that I could barely walk.

And so began a programme involving various types of stretching, golf balls under the feet, leg strengthening exercises and the foam roller. Oh – and having steel needles inserted directly into my knotted leg muscles, which feels exactly as it reads.

Foam roller

Foam roller. Agonised roar not included.

The icing on the rehabilitation cake though is my foam roller, a piece of molded plastic that I roll under my knotted leg muscles, producing fist-chewing levels of discomfort and instant sweats. The roller’s improved the condition of my legs considerably, and my lexicon of swearwords.

The treatment’s ongoing and the pain’s still present. But the physio’s allowed me three 5k runs a week at this stage, which has saved me from losing my mind (and my ever-patient wife from losing hers). I’m getting back from the sofa to the street, slowly but surely.

And I’m loathe to see a moral in all this, other than ‘don’t be an idiot, you idiot’.

As Joni Mitchell might say, I’ve seen toes from both sides now.

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