Saturday, December 5, 2009

Plantar Fasciitis (for Melissa)

When I was a kid, I never ever thought of myself as an athlete. Running made me wheeze, and I hated team sports because I knew I was going to let everyone down. In elementary school, I was always in awe of the tomboys among my friends who actually choose to play kickball with the boys at recess; I only played kickball when forced to by my gym teacher, and I was always the proverbially last-kid-to-be-picked. Even worse than kickball was volleyball. I had a natural reflex to duck away from a ball hurtling itself right at my face. The pain of a volleyball hitting my glasses right on the bridge of my nose is still vivid, and I probably haven’t played volleyball in thirty years. I will be quite content if I die never having played volleyball again.

In high school, I found a small niche for myself in the drama program, and never gave a thought to sports. In middle school, the basketball coach had half-heartedly tried to recruit me, simply because I was tall. But I would no sooner have joined the basketball team than a Christian youth group. As an adolescent, I was not even agnostic, not about God, not about sports: I rejected both pretty much out of hand.

So at the age of thirty-five, two miscarriages behind me and facing the stark likelihood that I would never carry a pregnancy to term, I felt pretty alienated from my body. For years I had assumed that though I was soft and not particularly strong, I had a body just meant to grow and nurture a child. Though I didn’t – and still don’t – care much at all about having a biological connection to my children, I did very much yearn to experience pregnancy and childbirth. I was sure I was going to be really good at it. As it turns out I was wrong.

I was also as heavy and out-of-shape as I’ve ever been after a couple of years of low-tech yet grueling infertility treatments, two miscarriages, depression and a sedentary desk job. I was heavy, out-of-shape, alienated from my body, disappointed that I would not experience the physical challenge of childbirth – and totally without any resources to draw from in facing those challenges. The conventional wisdom was that I should exercise, but I was so convinced that I was not an athlete, I didn’t even know where to begin.

I’m not sure what led me to my first lap around the track. That’s as far as I got that first time, one agonizing lap. A quarter mile. At the end I could barely breath and my thighs were burning. The next time I added half a lap, and the next time another, until very, very slowly-but-surely, I was up to two miles. I left the track out of sheer boredom, took to the trails in the woods, and – still the slowest runner in the park – I was, nonetheless, a RUNNER! An athlete. I would say to Julie regularly, “You know what, I think I’m actually a runner!” At first she was very encouraging, but eventually she began looking at me with a sort of “no duh!” kind of look on her face. But for the longest time I just never stopped being astonished. A runner! An athlete! Me!

Then I got a little cocky. Somewhere in the most secret recesses in my brain I began thinking that maybe I could really be a runner. Like run in races and stuff. I started looking into 5k’s, which seemed fairly reasonable, but my secret goal – unspoken to almost anyone, it seemed so absurd – was to run Broad Street, a ten mile race held every May in Philadelphia. In January, I started training in earnest.

You know what happens when athletes get cocky? They get injured. About a month before the Broad Street run, I was felled by a searing pain in my heel. I could barely walk. I had no idea at all what was wrong with me, but the pain was so excruciating and my devastation so dramatic, I feared my running career was over before it had really even begun. I was convinced that my body was never going to be my friend. Fortunately, I was wrong.

My friend Pete quickly diagnosed my malady as plantar fasciitis, and a little Googling suggested that this need not be the end of the world, though pretty clearly Broad Street was not in the cards that year (as it turns out, Broad Street has continued to elude me every year due to injuries). My Googling also suggested that if I had set out to inflame my plantar fascia, I could not have gone about it with a more targeted training program: I was running sprints, I was running up hills, I was running in sand. Oops.

It was a pretty major set-back. But confident that I would, indeed, run again, and with Pete as my coach, I set about healing my heel. First, I stopped running entirely for almost a month. I started wearing a brace at night that Pete loaned me, which kept my foot flexed. It was terribly uncomfortable, and usually I would kick it off before the night was over, but it really worked. I also got special inserts, again recommended by Pete, to put in my new gel-cushioned running shoes, which, for the first time, I actually spent some money on.

When I started running again, I started back at the beginning. Well, not all the way back, but I did go back to the track, which is soft and flat, and began with maybe a mile. I increased really slowly, and took it easy if the pain flared up. I’m not much of a stretcher, but I started taking care to do gentle stretches for the bottom of my feet. And eventually I was back up to my normal running routine, now with even bigger dreams in the secret recesses of my mind.

In my experience, plantar fasciitis is a permanent but manageable injury. My right foot flares up occasionally, usually when I get up to four miles several times a week. This just happened recently, but due to the genius of my friend and yoga instructor, Jen, I have recently had a bit of a breakthrough in my treatment. I’ve been doing private yoga once a week with Jen for several months, and because she knew I had suffered from plantar fasciitis in the past, she has been working very diligently at making sure my feet are planted very firmly and evenly on the ground, especially in my down dog.

“See that crease at your ankle when you’re bent forward?” she will ask. “Let’s make sure that’s even. Make sure your foot is evenly grounded, especially the big toe.” I knew this had something to do with my plantar fasciitis, and Jen really is a genius, so I trusted her implicitly and took care to be mindful of how my feet felt on the floor. But I wasn’t suffering from any heel pain – my running was great, though I was only going a couple of miles most of the fall – so I didn’t really get it.

Then just the other week, there it was, after just two four-mile runs, that familiar, stabbing pain in the ball of my heel. I prepared myself for a set-back, but didn’t despair. I don’t have Pete’s brace, but I started flexing my foot whenever I could. Started doing gentle foot stretches. And a new pair of shoes and new inserts are on my shopping list.

But the real key has been paying attention to my stride, both when walking and running. I tend to underpronate, especially on the right side. When I focus on making sure my foot is evenly planted on the ground, most of the pain in my heel just disappears. Since rolling to the outside of my foot feels natural for me, compensating means being especially mindful of planting my big toe firmly with each stride.

Soon I will be adding weekly Pilates sessions to my weekly yoga practice, and Jen and I continue to work on strengthening and re-orienting my legs to correct for the underpronation in my stride. And don’t tell anyone, but I think maybe I’m finally going to run Broad Street in 2010!


Mary Matthews said...

Great post!

Take care of that foot and work hard at protecting it. You might want to add cycling to your exercises too, since it will help build up endurance and strength in your legs!

I'll be cheering for you in May!!

Very best,
Mary (Matthews)

Melissa said...

Thank you for this. I still feel mystified by my pain -- how did I train for a 5K and do my 3x/week aerobics class all winter and spring with no problem? It wasn't until this summer and I slacked off that it started hurting. However, a big reason I slacked off is because I think I broke my little toe on that foot. Sigh. Anyway, I'm going to see what I can use from your experience and try to get on top of it! New shoes are first on my list.

Rebecca said...

Wow, very, very similar story to mine (in many ways) except my injuries (proximal hamstring syndrome and piriformis syndrome) were career ending. Very devastating. I'm so happy that you worked through/around/with it.

What Mama Sews said...

Loving this and want to try to figure out what Jen sees, as I STILL am struggling with my P.F., though delighted to be walking again as GOOD SHOES, GOOD INSERTS and rest (Gillie's pneumonia, no less) has boosted me forward. I've even been thinking about running and you're motivating me, girl!