Thursday, August 29, 2013

Killing My Plantar Fasciitis Beast

[This seems to be my most popular post, so I'll try to keep it updated as I learn more techniques for battling and defeating the monster. Happy running! -Scott]

So, you have plantar fasciitis (PF). Me too. Sucks doesn't it? In fact, I would say it's one of the most evil injuries that can afflict a runner. Pulled muscles heal in a month or two. Tendinitis can be managed while continuing to train. Even broken bones heal in 8 to 16 weeks.

Plantar fasciitis can last for many months. Or years. Or forever. It's evil. Pure evil.

I've had PF before, in my right foot. I tried all sorts of remedies and therapies but not much worked. Some things would help, but only temporarily. The PF always returned. Over the course of a year, I eventually worked out a seemingly effective treatment strategy.

Note: I am not a doctor, nor do I claim to be one. I'm just another knuckle-head runner with a blog. This recovery regimen worked for me, but don't blame me if it doesn't work for you. Your mileage may vary. Take with water before bedtime. Do not operate heavy equipment under the influence of this therapy. May cause hair loss and extreme boredom. Do not attempt these therapies if you do not have PF or if you have no feet. These statements have not been evaluated by the FDA, the FBI, or the CIA. The NSA denies the very existence of PF.

Calm The Beast
First, I had to get my PF beast to calm down and stop thrashing about it's cage. Here's what I did.
  1. Stop running. Don't panic! It wasn't a long break. I gave my foot about 2 weeks to recover from the inflammatory injury cycle (i.e. running) that I had been putting it through.
  2. No, really, stop running. Yeah, you saw me out there, limping along. OK, I'll head back to step 1.
  3. Reduce the inflammation. This is tricky. Inflammation is required in the body's feedback loop of healing, so I didn't want to eliminate it entirely. But I wanted to reduce the pain and inflammation enough to begin the actual recovery exercises. I didn't go on a 2400mg per day regimen of ibuprofen in an attempt to be pain free. That wasn't the goal. Actually, I just avoid NSAIDs like ibuprofen entirely when possible, mostly because I value my colon (don't ask). Topical anti-inflammatory creams worked, but I had to use a lot since the skin on my feet was fairly thick.
Herd The Beast
Second, I began herding the beast towards the slaughter house. I followed these steps on a daily basis until I was pain free.
  1. Deep massage. If you've had PF for a while, you probably have a nice little build up of scar tissue. I sure did. Deep massage using my thumb helped break up the scar tissue and started realigning the collagen fibers of the fascia. Think of the injury site as a pile of collagen fiber spaghetti with scar tissue meatballs. Deep massage started breaking up the meatballs and aligning the spaghetti strands. I massaged from my heel towards to my toes, just because that was easier. Warning: In the beginning this hurt! You will likely feel (and possibly hear!) crunchy areas along the fascia as you run your thumb along the tissue. However, the pain will become more tolerable after a few sessions, and the crunchy bits should slowly disappear. Another more advanced massage technique I tried was rolling a hard ball under my foot, back and forth across the plantar fascia (from heel to toe and toe to heel). I used a pool cue ball, but a golf ball or something similar would probably work just as well. This provided both massage and stretching of the plantar fascia. And speaking of stretching...
  2. Gentle stretching. There are several ways to gently stretch the plantar fascia, but I had a favorite. I sat in a chair and crossed my afflicted leg on top of the other leg. I placed the ankle of my crossed leg on top of my knee, allowing the foot with PF to hang slightly to the side. I held my heel in the palm of one hand and wrapped my other hand over my toes and around the ball of my foot. Then I pulled the ball of my foot towards the knee while bracing the heel with my other hand. When I did it correctly, I felt a gentle stretch in the arch of my foot. Go here for another description and to see the source of this picture. 

  3. Ice Is for Drinks. A lot of people will tell you to ice the fascia as part of recovery, but I disagree with this approach. Icing can indeed help to reduce the inflammation early in the recovery process, but it won't help you heal the damage, unless it is coupled with heat. That's right, heat is what you need! Increasing blood flow will help with healing and nothing beats the cooling and heating technique for increasing blood flow. My technique is to use a frozen water bottle (plastic) as a sort of roller. Roll it under your foot until you have achieved a nice cold foot (wear a sock to prevent frostbite!), then switch to heat. I used a heating pad for the warming stage, but rolling with a bottle of hot water would work just as well. Alternate the cooling and heating as often as you can throughout the day.
  4. Strengthen the feet. Believe it or not there are muscles in your feet, and they can be strengthened. My favorite strengthening exercise was the foot "scrunch". I did this while sitting (easier) or standing (harder). The idea is to scrunch the foot by pulling the toes and ball of the foot towards the heel using only the muscles of the feet. I started in a seated position with my foot flat on a towel which was lying on the floor. I then attempted to scrunch up the towel using only the scrunching motion of my foot. Once I was able to do that proficiently, I wore a sock and performed the same foot scrunch while standing on a smooth floor (no towel required since I had learned the proper form from the sitting scrunches). Three sets of 10 scrunches a couple times a day really helped me after a week or two.
  5. Wear a boot or a sock. I was very reluctant to wear a boot at night. I didn't think I needed something so drastic. But the boot seems to help the fascia heal in a more neutral position, so I eventually got a boot and wore it to bed every night. I regretted not doing it sooner because my foot felt much better almost immediately once I started wearing the boot. Don't worry, I didn't wear it forever. Every few weeks, I would sleep without it for a few days. Each morning I would see if I could take a pain free step out of the bed. Once I had a pain free week without wearing the boot, it went into the closet. If you can't stand the boot, give the strassburg sock a shot. It's much easier to sleep while wearing the sock and it keeps your foot in same position, with the added benefit of putting a slight stretch on the fascia

Kill The Beast
OK, it's been pretty standard protocol up to this point. Now we get to the hard parts, and some would say the controversial parts - lifestyle changes. Yeah, sorry, but the only way I was able to truly kill the PF beast was to change some aspects of the way I live and exercise.
  1. No arch support. Yeah, seems counter intuitive, but believe me, I wasn't doing my plantar fascia any favors by perpetually propping it up on top of arch supports. Using arch support, my plantar fascia would heal, and I was even been able to run again, but it never became strong and PF resistant (PF came back regularly). The only way to ensure development of a strong, healthy plantar fascia was by actually using it as intended (as part of the spring complex in my foot's arch).
  2. Run barefoot. I wanted strong feet, so I sucked it up and ran barefoot. I don't care if you think it's hippy trippy dippy crap. It worked for me! I'm not saying I ran exclusively barefoot. I just added some barefoot running (or even walking, but preferably running) to my normal training. I ran barefoot once every week or so, not more than a mile or two. It didn't take much barefooting since I was gaining foot strength by running without arch support, but it did seem to be necessary to get back to 100% foot health, at least for me.
  3. Stand up. Aside from the other health benefits of getting off your arse, standing is good for the feet and legs. I started using a standing desk at work and spent most days on my feet. I would stand and balance on each foot for several minutes at a time during the day. If I got tired, I sat down, but I tried to spend more time standing than sitting. Sitting is nearly as evil as PF.
  4. Roll the calf muscles. Yes, really. Tight calf muscles (or muscles with painful spots/knots) put persistent pressure on my achilles tendon, which put persistent pressure on my plantar fascia. I bought a foam roller and went after the tight spots in my calf muscles. If you are a masochist, you will really enjoy a "fun" session of rolling out the knots in your calf muscles.
  5. Get Stronger! Not that I'm calling you a weakling, but you likely have PF because something in your rear chain of running muscles wasn't balanced, or you increased intensity too quickly and your strength levels were insufficient. Either problem would result in what I (and many others) would call "calf running", where your calf muscles and feet are overloaded because your hamstrings and glutes are on vacation or are overwhelmed. So, hit the weights! Yeah, I know, you're a runner, not a weight lifter. But you are now an injured runner, so just get in there and work on strengthening your hamstrings and especially your glutes. My favorite weight lift for rear chain strengthening is something called the "good morning squat". 
My right foot has been PF free for a couple of years now. I expect to kill the beast in my left foot in short order.

Update! I did indeed kill my PF, but it took longer than expected, due mainly to the fact that I had partially torn the fascia near my heel (don't run a marathon if you are already hobbling around with PF!). This required 6-8 weeks of absolutely no impact training and a boatload of patience on my part. After the healing period, it was a long slow road to recovery using the techniques described above, but I did indeed finally beat the PF. Being mindful of my feet and maintaining more balance (see Get Stronger! above) has been of very important in maintaining foot health. My foot has been great since defeating PF, and has held up just fine in 17, 20 and marathon length trail races.

If  you too have PF, best of luck to you in your quest to kill the beast! I'll be cheering you on.

Tuesday, August 27, 2013

How To Give Yourself Plantar Fasciitis

Ahhh, plantar fasciitis... Welcome back old friend! I've missed you so. It's been years since I gave you the boot from my right foot (Ha!), and I've wondered why you never came back. I guessed that it was the occasional barefootery in my running routine that was keeping you at bay. Or my shift to a standing desk at work. Or perhaps that we had simply outgrown each other. After all, I had moved on. I'd run several marathons and even a couple of ultra marathons with nary a whisper from you. I assumed you were now miserably married to some other runner's foot, and that was fine with me.

And then, seemingly out of thin air, you show up at my footstep. Finding the doorway to my right foot firmly locked, you slithered under the archway of my left foot and latched your red hot claws onto my heel. But how? I'm usually attuned to every whimper and creak coming from my feet and knees. Why didn't I see you coming? Could I have seen you coming?

I Should Have Seen This Coming
Well, as usual, I have only myself to blame. Want to give yourself plantar fasciitis so you can suffer with me? Here's a sure fire formula:

  • Run faster. No, really, FASTER! Take your normal training paces and knock off a good minute. Now, attack every run for the next month at your new faster pace. Pat yourself on the back and brag about your newfound speed on your favorite run tracking website. It will add some zest to your future humble pie.
  • Race in new shoes. And I mean race! Break some long standing PR's by totally flailing your body through the last mile of the race. Make sure you lose all semblance of proper form in that last mile. Slam your heels into the ground on each stride, but remember to wear shoes with absolutely no support and no cushioning. We don't want any shoe technology to perhaps save you from yourself.
  • Cross train in stupid ways. I don't just mean the normal sort of overdoing it with CrossFit or the like. Find some activity that isn't even tangentially related to running, and commit to it with idiotic zeal. Springboard diving at your local pool is a nice choice. Slam your feet onto the board and spring off your toes with all your might. Repeat this until your feet hurt so much you can barely walk away from the pool. Now, go jump on a trampoline until your knees buckle.
  • Skip recovery days. Even though your knotted calf muscles look and feel like cheap plastic shopping bags full of golf balls, and even though both achilles feel like leaky, acid-filled surgical tubing, don't you dare take a break! Recovery days are for the weak. You are a badass runner. Just look at those new, faster paces!
  • Ignore the pain. Pffft! You call that slight burning sensation in your foot "pain"? Run an ultra-marathon, then you'll know pain. Remember, you are a badass runner! Use pithy movie quotes to rationalize your stupidity. Tis but a flesh wound! You ain't got time to bleed. 
Stay tuned for my next post, where I'll tell you how to get rid of plantar fasciitis. Really.

Sunday, August 25, 2013

The Revenge - Raleigh 8000

Why haven't I run the Raleigh 8000 before now? The 8K is the perfect Summer time race for a distance runner like myself. It's too long for the brutal, puke-tinged efforts required for the 5K, and too short to worry about fueling or hydration. After a fun experience at the Running of the Bulls 8K earlier in the Summer, I'm really starting to love the 8000 meter race.

Not that I'm particularly gifted at the 8K discipline. Or any discipline for that matter. I'm too willing to sacrifice discipline for beer. Or food. Or rest. Or a dentist appointment. Or anything less painful than the hard, sustained efforts required for middle distance training. What was I saying before? Oh yeah, I really like the 8K distance. I'll just never be any good at it.

Regardless of my own innate inabilities, after I learned that the Raleigh 8000's primary beneficiary was the Autism Society of North Carolina, I decided that the beautiful wife and I would run the race. Being the parents of an autistic child, we try to support anything that benefits autism services. Besides, our marital rivalry seems to be drifting towards a pure 8K rivalry.

So, when I woke up the day before the Raleigh 8000 and could barely hobble to the toilet due to the what felt like a broken left heel, I didn't know if I would be running or walking the race. But I was determined to make the distance. I'll save my "Achilles arrow to the heel" story for a later self-pity post. Please come back for a visit to weep with me in the comments section. Or to tell me to just suck it up. Works either way for me.

Enough useless blog banter, on to the race!

The Race

I've been running for several years now, so it's really cool to show up at a new (for me) race and see lots of familiar faces and friends. I think I parked next to the stonking fast Umstead Trail Marathon women's champion, Lorraine Young (3:03! On trails!), but I wasn't sure, so I didn't pester her with introductions (it was indeed Lorraine and she finished as the top female with a 5:55 pace. Whoosh!). Turns out I know the race director, Michael Forrester, since he also happens to be an organizer of one of my favorite trail races, the Medoc Trail Marathon. Plus I saw about a half dozen other trail running friends before the race. Too cool!

Sold out. Full of fasties.

The course itself is a beauty, and devilishly difficult. After a steep downhill followed by a short rise on Six Forks Road, the course hits the greenway trails for a beautiful, meandering run down to the Shelly Lake dam, including transit though a very dark, cool pedestrian tunnel. The race to the dam is essentially 2+ miles of gentle down hill running. Fast! After crossing the dam, you circle around the lake and then retrace your steps back up to the finish line. If you've gone out too fast, your legs will melt down and you'll find yourself walking back up the hills. Pace yourself just right and you could end up placing in the top 3 of your age group.

Downhill start. Whoosh!

Onto the beautiful greenway trails.

Through a very dark and wet tunnel.

Across the earthen dam of Shelly Lake.

Across Shelly Lake on the boardwalk.

Back through the wicked cool tunnel.

Gut busting uphill finish.
Just an awesome course! Do yourself a favor and run this race.

The Rivalry

The beautiful wife and I have our own unique ways of approaching our running rivalry. I stress about the rivalry before every race, while the wife denies the very existence of the rivalry. But that mind game doesn't work on me. I know she knows. Wait, maybe the denial is a ploy just to get me to know that she knows. But that means she knows that I know that she knows. Chicken! Egg?! <my head explodes here>

Unfortunately for the rivalry, we were both not in the best of health the weeks prior to this race. The wife slipped a disc in her lower back doing yard work. Those of you who have back problems will understand. For those of you who have never experienced the joy of a disc problem, imagine someone hammering a red hot iron plate across your lower back with dull, rusty nails. Then imagine that your legs only work at 50% capacity because most of the nerves controlling them are too busy firing nuclear pain signals into your addled brain. Now, multiply that by 10. Perfect.

My own "arrow to the heel" problems I'm reserving for a later post in the continued hope that my stupidity will help others. Or at least amuse others.

So, we both tacitly agreed to call off the rivalry for the Raleigh 8000 and just run the race together in honor of our son.

The Revenge

Little did I know that my wife's back had mostly recovered and that she was in surprisingly good form. While I spent the race scampering around taking pictures, she cranked out mile after mile of 7:45-8:30 pace. And even though I refused to let her pass me on the last big hill, she had the last laugh, placing 3rd in her age group and winning a beautiful pint glass! My prize was being unable to walk without limping for the rest of the afternoon. Oh, how I covet my wife's pint glass award.

Image blatantly stolen from my
my friend Ash's race report from
two years back.

Well, the free post-race beer courtesy of sponsor Sawmill Tap Room took away some of the pain, but I won't be fooled again.

"Oh, you'll be fooled again. Definitely."

Sunday, August 11, 2013

The Drinking Game - C.R.A.P. Fest

I know you're wondering, what's the C.R.A.P. ? Let's just get that out of the way before I get to my tale of drinking while running. C.R.A.P is an acronym for Countdown Run And Picnic. The full, official title of the event is "Jimbo's East Coast Countdown Run And Picnic", but in it's second year, it has lovingly become shortened by most participants to "The C.R.A.P. Fest." Jimbo" is Jim Plant, a local ultra runner who has moved to the West coast since he originally organized the event last year. This year the race was organized by Tim Preble, another local ultra runner. Tim did a great job with the event this year.

Why have an event with a name like C.R.A.P Fest? It's an ultra runner thing I think. Keeps the riffraff out. Only diehard ultra running nutjobs would be willing to suffer though an event with a name like that. I don't consider myself an ultra runner, but fortunately, I love crazy running events, so when I saw one of my Facebook friends comment on the event, I busted in and asked if I could participate. Ultra runners being some of the coolest, nicest folks on the planet, welcomed me to the event.

How C.R.A.P Works 
The race is devilishly simple. Repeatedly run a 1.6 mile trail loop in an ever decreasing window of time. To start you are given 37 minutes to finish the loop. The equivalent of an easy stroll around the trail. After 37 minutes, the next loop run begins (usually counted down with sadistic glee by race organizer Tim). This time you have 36 minutes to finish the loop. And so on, and so forth, until you can either run no further, or you miss the group start of the next countdown loop. Like this:

Jimbo is either mad, or an evil genius. Maybe both. My kind of guy! I really want to meet Jimbo if he ever comes back to the East coast.

How C.R.A.P. Feels
On a normal day in North Carolina, in August, you would sit on your front porch sipping something cold and refreshing. In my case, a chilly pale ale would do the trick. They don't call these the dog days of Summer for no reason around here. Just getting out of your chair to retrieve another tasty, cool beverage can result in sweat stains on your favorite shirt. Now, imagine running to the store, which is nearly a mile away, to retrieve your favorite beverage. Now imagine doing that over and over and over and over... After 5 hours of this, I was thinking good god, just shoot me!

250 yards of sweltering sun. I started calling this section The Oven.
That's the giant Jordan Lake earthen dam in the distance.

Tyler Peek's strategy was to go fast.
Every. Single. Lap. 

Don't get me wrong, I had a great time at the race! These small FA ultra events draw some really cool people. I had a good time chatting with different people on the loop repeats and in between loops at the shared aid table. Speaking of the shared aid table, don't be an idiot like me and show up for the race with no fuel and a single 20oz handheld full of water. You will utterly self destruct with such foolishness. Thanks to the kindness of the more seasoned ultra runners who brought shared snacks, and especially thanks to the race organizer ,Tim, who brought at least 30 gallons of cold water, I managed not to die during the race. Even with drinking 20oz of water after each loop, I was still peeing apple juice after 3 hours. Totally brutal day on the trail for sure.

Smart runners showed up with more
than just a 20oz handheld full
of water. 

I would have died without this stuff on the
shared aid table!

Crapping Out of the C.R.A.P Fest
The great thing about this race is that the strategy and execution is entirely up to you. Run hard and fast and take long breaks between the loops early in the day, or take your time and try to just maintain a continuous momentum. This being my first attempt at the race, I tried both strategies at different points in the race. Early on, I ran way too fast (19-21 minute loops). In the middle I walked more (22-24 minute loops). My last lap was my slowest at 28 minutes, when I crapped out at 17.6 miles. Looking back on it, I think I totally reversed the proper strategy. That's just about right for me.

Was it hard? Hell yes it was! Was it fun? More than you can imagine. Would I do it again? I'm already planning my return to next year's C.R.A.P. Fest.

A couple of other race reports can be found here, and here (second place overall!).

Sunday, August 4, 2013

Hallucinogenic Weight Loss - Medoc Meltdown 50K

Wanna lose some weight? Wanna lose some weight and totally roast your brain? Wanna have an awesome time? If you answered yes to any of these questions, follow me to the Medoc Meltdown 50K Fat Ass event next year, because the free hallucinations at Medoc are done for this year.

If you are not familiar with Fat Ass events (hence forward, abbreviated FA to avoid triggering the NSA terrorism profanity filters), let me try to explain them. No, there's too much. Let me sum up. FA events have no fees, no awards, no aid, and no wimps:

  • No Fees: Free! The events are totally volunteer driven, usually by your fellow awesome runners. You pay nothing and you get way more than your money's worth.
  • No Awards: What? You want some cheese with your whine? Suck it up and run!
  • No Aid: Self supported. No aid stations. What part of "free" don't you understand?
  • No Wimps: Nobody at a FA wants to listen to your bitching and moaning, unless you do it with a smile on your face. Remember, you are here because you want to be here!
By FA standards, Medoc Meltdown is top notch. Not only do they break several of the cardinal rules of FA events, but they take pride in doing so. While keeping the event free, there are still awards for the nutjobs willing to slog it out for 50K on a steamy August day in North Carolina. OK, the awards are painted rocks, but my gawd, did I want one! And am I ever jealous of the crazies that actually finished all 50K to "earn a rock". 

No aid? HA! There was water and gatorade available at the start/finish of the 8+ mile loop which was also accessible from the half way point of the loop. So, aid was available about every 4 miles. That's better than some "real" races I've run.  And I won't mention the freeze pops, cookies, Coke, potato chips, and pickles available for the runners. And I definitely won't mention the hot dogs that were sizzling on the grill. That would just be cruel for you people who thought this FA was aid free. 

No wimps? Again, HA! I attended, so that rule was shattered as soon as I ran my first step. However, I will say, this is a serious running endeavor. And by serious, I mean f'n difficult! 

Half Assed
I managed to complete 2 of the 4 laps (for about 17 miles) in just over 3 hours, and it was probably the hardest 3 hours of running that I have done. A hard ass half ass! It wasn't the horse flies. There were plenty of those diving at my head like tiny, angry, fighter jets. It wasn't the snakes. The two giant black snakes I saw laughed at me as I ran past. Not worth the venom they snorted. It was definitely the humidity. 

Humidity Hallucinations

I'm a NC native, so I'm familiar with the dog days of Summer humidity around these parts. But this was just insane. My glasses kept fogging over, and my camera totally fogged up after an hour of riding in my sweaty pocket. I swear my eyeballs fogged over too. 

By the time I finished my second lap, my shorts were dripping with sweat. Not my shirt (I didn't even bother wearing one). My shorts! And I started hallucinating during the last couple of miles. Weird, foggy shapes drifted through the trees. Trees gently swayed in a breeze that didn't exist. And talking snakes slithered across the trail in front of me. I'm pretty sure Medoc isn't the Garden of Eden, so my brain must have truly been melting down. It was so incredibly awful that I plan to go back again next year and try to complete all 4 laps.

I've spent the past 24 hours attempting to rehydrate my desiccated body with quality beer. It's not working, but I feel pretty good. I'm also trying to figure out how I'm going to run 4 loops next year to earn a rock. I figure if I can at least hallucinate that I ran 4 laps, that will be good enough. It's a FA after all.

Nothing gets between me and
my Calvins. Except sweat.
Photo courtesy of Frank Lilley.