Wednesday, August 31, 2011

"The Heel" - it's not a foot problem

I have wanted to write this post for a long time now - a post about the history of my heel and all I have done for it over the past...well, essentially two years; and how I am - thankfully - now on the mend.  Crazy, busy, amazing summer got in the way and I wanted to share that with you, too (and heaven forbid I write more than once a week :)): Mt. Whitney, the Wild West Relay, numerous mountain runs, and of course my Pikes Peak Ascent race - which, btw, thanks for all the thoughtfully wonderful comments on my last post.  That race truly tested every ounce of mental  and physical strength I had - a highly emotional day - and it meant a lot to me for your very kind words.  I'm kinda needy like that.

Additionally for my heel writing absence, though, is this whole ordeal is a rather complex concoction of so many crazy factors and truthfully, most of it is beyond the scope of my pea-sized brain; it's been hard to articulate the words logically (like that's ever been a problem before, eh?).  But one thing I have learned throughout this mega month foot nightmare, Plantar Fasciitis in runners is NOT a problem with the foot and no amount of icing, rolling, orthotics, stretching - and especially taking time off from running - is going to fix it.  It may slap a temporary Band-aid on it, but it is absolutely not going to fix it long term.

Let's be realistic....if one is injured, there's a reason behind it.  Duh.  But the vast majority of injuries runners endure are not because we didn't stretch enough, ran too far, or over-trained - contrary to popular belief.  The body is pretty adaptive to the stress we put it though but if there is an imbalance in our body somewhere, and you repeatedly stress it with this imbalance, our bodies scream with an injury.  My foot problem wasn't because I ran too much....if so, why isn't my other foot angry?  I mean, I do try to run with both feet.

What I have learned - and not the easy way either...remember the failed cortisone shots, the boot, the time off running, the dry needling in my calf - is this:  My PF and AT issues stemmed from:

- A prolonged running history of over-striding and thus heel-striking.
- A prior strained calf muscle in my "bad" foot.
- Weak hip rotators - especially on the side of the "bad" foot.
- Weak glute muscles - again, especially on the side of the "bad" foot.
- Weak core muscles
- Improper footwear (aka: traditional beefed-up, cushioned heeled shoes)

Plantar Fasciitis and Achilles Tendinitis in runners is fairly common, I can't even tell you how many people I have met with this problem through the blog, out for a run (the last mile of Pikes Peak Ascent a couple weeks ago even), people at work, people who know runners with it's endless.  And it makes me angry when I hear all the things they are trying to do, because they are getting the same crappy advice I got from my podiatrist early on in this game.  I could go on and on about that yet I won't, but suffice it to say, I copied a few pages out of the book Born to Run and handed them to my podiatrist and told him I wouldn't be back.  I'm sure he didn't care, he lives in a house 30x the cost of mine because people buy into needing surgery or an orthotic to "fix" this mess, but at least I felt better.  I was fortunate enough last spring to find someone who heard my plea to find a solution to the cause, not a quick fix Band-aid.  I have always believed that the reason I had this was due to something I was doing incorrectly with my mechanics and I begged the world to listen to me.  I showed my old shoes to my podiatrist, asked him to notice the abnormal wear patterns on the right shoe, to which he replied, "Jill, I fix Olympic Marathon runners with this, surely I can fix you."  F-you, Dr. Farrett!!  Oh yeah, I wasn't going to get into that, I momentarily forgot ... the guy gets my blood stirring with his arrogance.  But back to the "other guy", Ron, a physical therapist, who found my blog and heard my cries.  Ron has been instrumental in getting this fiasco over a few humps, around many corners, and returned running back into my life.  He instantly identified what was wrong with my foot, he has fixed many runners like me in his clinic and told me my problem was easily fixable - with time and hard work.  Here's a few words Ron wanted to share with you:

Jill represents a funny population of people.  Not funny ha ha but funny as in multiple factors influence finding herself in severe heel pain. She ran herself into pain using sound running plans and history of running.  She developed weakness that led to poor running biomechanics, poor biomechanics led to using her anatomy the wrong way. 

Our bodies are resilient.  Our bodies will find a way.  We as a society continue to find easier more convenient ways of doing things.   In order to run better you have to run – but run properly.   Run, but use good running mechanics.  Strengthen the right muscle groups, use the muscles the way they are designed and teach the foot to work appropriately. 

Jill is beginning to turn this ship around and to her credit she has a huge heart.  I love it when people love running as much as she does and that is why I reached out to her.  It breaks my heart to see someone want to run so bad, get such crappy advice, and continue to look for answers.  I do not know she if is doing the exercises I’ve given her correctly or with the right resistance and I have not been able to do a gait analysis, and I have not done any education on why she is running with less efficiency then she should.  The ground reaction force is still too high and her body is not able to handle the force.  Although I have not tested her, my guess is that her calves are extremely weak and her hip external rotators/extensors cannot control her hip/femur.  When this happens her knee does something silly.  A silly knee makes the foot do something even sillier and her heel is fed up. Despite that she is feeling her way back to marathon training. 

When Jill looked for help to find a solution to the pain rather than a quick-fix it did not come.  I cannot stress enough to find health practitioners who are experienced with running.  Everyone will say they are, but ask for proof.  “How many continuing education courses in running have you attended?  How much do you run? How many runners do you see a day?”  I have been to 6 running courses, including 3 times to the University of Virginia Running medicine (top researchers in running in the country) series of super relevant information to running health care providers.  I run 4-6 days a week, so I can train properly myself so I can relate to what you are going through.  I see 3-6 runners with this problem a day; beginners to BQers, and I am able to turn this foot pain around for them.  The informed consumers get what they are looking for.

Ron writes for a professional health blog HERE, please read his articles (and please hit "like" if you could), they are filled with a lot of information every runner can benefit from.

So, what does all this mean exactly?  Well, I'm running - and not just running, I've been given the green light to start marathon training!!!! Two years of heel pain, 13-months of which was so excruciating I could barely walk, and finally I am running virtually pain-free.  It hasn't been easy, when I first started the mid-foot strike, I thought I was going to poke my eyeballs out, it was so slow going and I really struggled with my bad foot.  But I was persistent, and after I finally decided to let the impatience go, things started to turn around.  My foot's not 100% but I'll take 90% and manageable any day over what I endured the past two years.

Monday was day 1 of a 21-week marathon plan I worked up over the past weekend.  I have never had to start from scratch on all levels: pace, strength, speed and endurance; this will be the biggest obstacle I will have to overcome since I started running over 35 years ago. 

I'll be honest, this is going to be one of my toughest battles I've ever had to face.  But don't we often love the things we have to fight for and sacrifice and claw our way to the top?  My talent for marathon running is minimal at best.  I don't love swimming as much as I love endurance running and I actually have a talent at swimming - it comes easily which makes it often feel cheap (well, it did, back in the day anyway).  But I love the conflict and grit that comes with marathon training; I appreciate the reward so much more if I give something up and put in the work.

I encourage anyone with a running related injury to keep knocking on doors until you find the solution to your problem.  Most running injuries are a direct cause of a biomechanical issue caused by a muscle imbalance.  Every runner can benefit from a muscle test from a physical therapist - I promise you, you will learn so much about your weaknesses and more than likely, it's an easy fix that with patience, you can turn around and run injury-free. 

I'm living proof. 

I got the green light, let's get this show on the road!!!!

In other (quick) news:
- My son, Ryan, is a sophomore on the cross country team which I help coach.  He has worked so incredibly hard over the summer at training camp and on Saturday, he knocked out a 19:15 5K on a very tough course in 95 degree weather .... and landed the last spot on the varsity team!!  I was crying with joy - literally - it is very difficult as a sophomore to earn a varsity position and though he may not keep it the entire season, I am thrilled he gutted it out and landed it for that race.  Is this a look of total determination or what?  
- And lastly, I'm dealing with a pretty difficult time with my daughter which has taken me away from a lot blog reading.  This, too, will pass in time, but my heart aches for her and I sincerely apologize for not being around more.  I will catch up soon.

Run Strong, my friends!!  :)


Paul said...

First comment! 8)

This posting is GOLD. I hope it helps a ton of people!

Raina said...

Jill, I am SO glad you were able to get to the root of the problem with your heel and that so many other readers here might use this to get some sound advice.

YES! Get on with that marathon!!!!

Congrats to your son! Super speedy and varsity!!

Amanda@runninghood said...

Jill, I loved this post on so many levels. I read parts of it out loud to Waylon too. He agrees with so much you have to say. Your words gave me chills here as you talk about your start to marathon training. Jill, it is apparent how much you love much.. and your determination and strength through this entire process is inspiration to us all. Seeing you reach this next marathon goal is going to be energizing beyond words!! I'm in the stands cheering already...can you see me? And Jenn is next to me with one of her big ol' signs! ha! You're such an example to your kids, us, and so many others. I "liked" the link you linked and I will check out their blog too!
congrats to your son! This is fantastic!!
And again, sorry about your daughter and what it means for her and you. You're on my mind girl!
Gosh, you have me inspired to do another marathon! GO JILL!!! xo

XLMIC said...

Yay!!!! This has got to feel SO good! I am smiling a mile wide for you, my friend :)

gary said...

uh oh. after reading this i think my heel is hurting.

Char said...

Your story is such an inspiration - of how persistence will pay off, of how the will will find a way. Congrats to Ryan - he's a chop off his maternal block.
Hope all goes well with your daughter. Sometimes I think that parenting is one of the most challenging things we can ever do.

Jamoosh said...

Oh come on - you are funny ha ha!

Interesting stuff. It will be cool reading how you progress.

Black Knight said...

Great post, I have many things to learn again.
Your son is really fast, he must go on with running.
All the best!!!!!

Anne said...

I was lucky to find a PT that took me through this process right from the start...looking forward to following along :)

Congrats to Ryan...and yes, this too shall pass with your daughter. Big hug ((()))

Jenn said...

OK-Jill! I've read this whole post, I could type about 15 paragraphs! I am heading to work and it's not worth even starting but I PROMISE I will be back tonight!! Thinking of you this morning and your daughter. OK, real comment in a few hours.

C2Iowa said...

Where to begin? Well, I have to say "Thank God". Your are on your way back! You didnt say which full..?..

Ryan - Awesome. Of course.

We still need to talk about training. Drop me a line.

Ewa said...

I read this post once and now I will study it. Lots and lots of good information Thank you!
Good luck with your training. Keeping my fingers crossed.

Adrienne L. said...

What a cool story-made me smile today! You've come a long way, stayed the course and should be proud!

Props to your son too! That is awesome!!

For some reason, this post made me think of Alberto Salazar's quote on my bud Leah's blog: "We may train or peak for a certain race, but running is a lifetime sport". Hope I didn't just butcher it:)

Run Happy!

misszippy said...

You need to take your running self up to the top of one of those mountains and give a big 'ole scream of joy! So great Jill that you have reached this point. I agree 100% with all you said and especially with the part about continuing to knock on doors. Yes!

Tara said...

Whoohoo for marathon training! And girl, you know you love swimming, just admit it Swim With Jill!

OH yeah, I was injured because I have horribly weak hip abductors, tight hip flexors, and a weak core that couldn't even hold my SI joint in place. I've learned my lesson and am now doing a great deal more strength work. GROAN.

Congrats to Ryan, he's as awesome as his mommy. :)

Mike said...

Very informative post. Green lights for marathons are always exciting!

readgirl said...


So glad to hear you are back on the mend. Maybe another Dallas White Rock will be in your future. If you're lucky the temperature might drop below 100 degrees by then!

Congrats to Ryan! Did you know that Jenna is running Cross Country now. She had her first meet last weekend.

Hope all is well with A. now.


Julie said...

I'm so glad you are running again!! Training for a marathon, even!! WOOT!! When I came back from my injury earlier this year, I felt such exuberance for everything running - isn't it the BEST feeling to be running again?!

I'm so sorry your daughter has to go through whatever it is that is going on. Take care of her and you!!!

ShutUpandRun said...

I really loved reading this start to finish success story. U never gave up. Ron sounds like a real gem, I will check out his stuff. Injury haunts most of us, and we have to dig deeper. Which marathon? Did I miss that part?

Ron said...

Jill! Thanks for the publicity! What a great post and I am grateful for the kind words. Keep up the good work!

Shellyrm ~ just a country runner said...

Great post! This will help a lot of runners who are suffering. So glad you found Ron or he found you. ;-)

Congrats to Ryan and you, proud mamma!

I'll be praying that your Abby is okay.

Anonymous said...

Yay Jill! Glad to read that you are on the mend and Ron sounds like the real effing deal!!

Anonymous said...

soooooooooo glad to read this! yay for a finished story :)

Julie said...

I know I've told you but I will say it again...I am beyound thrilled for you that you are running and doing so with out the pain you've been having for so long. I can't wait to cheer you on as you train for the next 20 weeks.

Way to go to Ryan that!!!! WOW! How awesome is that!

Hugs to you and your daughter. Sorry that she is having such a rough time.

Kandi said...

It's so nice to read about your journey and know that you are now on your road to a marathon!!! I can't wait to read about your training.
Congrats to your son for making varsity!! I ran cross country for 3 years in high school and LOVED it. We were a really small team (only 10 girls and maybe 14 boys) but managed to win states twice in MD while I was there. I squeaked into varsity my sophomore (first) year but not as much competition with only 10 of us.
I'll be praying for you and your daughter. I hope everything is ok.

lindsay said...

Thats how our medical system is -- bandaids. Treat the SOURCE? What a concept. I wish ALL docs got into this mindset, but then again they wouldn't make as much because people would actually be healthy... Too bad chiropractic care doesn't fix *everything*! (Been going to one since birth practically).

Anyway. I'm glad you stuck to your guns on your theory and found someone to work with you! HOORAY for being pain-free again!!!!!! What a load off your back :)

Caroline said...

happy for the no pain...
happy for your son..and congrats! that is a big deal!!!

I dont know what is wrong with your daughter but I hope it all gets better is hard for a mom to see our kids hurting

Terzah said...

I was having a grouchy, grumpy day until I read this post. I am so happy for you with that big open road of marathon training ahead for you at last. You have already been such a great friend to me and I've never even clapped eyes on you. Congratulations! I will be your biggest cheerleader and if your race is a nearby one I will be there to cheer you on.

Oh, and warning taken! In my next training cycle, I'll be paying more attention to my own weak hip and core. A little prevention, right?

So many more beautiful mountains for us to climb! I can't wait!

Anonymous said...

we're all behind you sweetums! you have a fantastic outlook, there's nothing stopping you now!

**this was a great post.


Catherine said...

I NEED to move to Colorado. No, really. I really want to get there but have no idea how, or where to start. Overwhelming!
Yay to finding someone who truly understands! I really love the words Ron shared about you.
Varsity. Wow!
Daughter....we'll be here when it passes. It'll all work out! ;-)

mtnrunner2 said...

Jill, what a great outcome! Injuries, especially tendonitis which tends to be slow-healing, are hard to bear.

I may look up your doc, I want to consult someone about running mechanics with regard to my knees, which were getting sore midway into the summer (I'm currently taking a break). Also still have a touch of PF.

Ana-Maria RunTriLive said...

So happy you are running again!!!!
Yes, injuries are complex. I might add that stress is a huge contributor to injury. Stress releases cortisol and lower the immunity, hence the body has a harder time healing what would otherwise be normal wear and tear pains.

Velma said...

I could not be more happy for you! I just signed up for a whole body evaluation so I can join you back on the road. I know you are going to rock that marathon. It will be tough but that is why it is worth it! **HUGS**

Alma said...

This is so timely, Jill. I sit here with my strained calf on the mend and now able to run 25 min every other day. This is the second time my calf has torn, same leg, same spot. I have weak calves, especially the left. I have a weak hamstring on that side, and my hips are tight but weak. Oh- and I'm always just barely keep PF at bay after taking 1.5 yrs off with that in college. Ug! I AM all your bulleted items - overstride, big shoes, hips, calves, etc. I have now found a phys ther who rocks and is helping me make my hips solid as rocks so I don't dip, sway, and let my knees & ankles do funny things. He's also working on some lower back issues that also play into it all. !! I haven't worn my orthodics now in about 10 months after running in them for 18 years and I'm slowing trying to rebuild my stride to a mid-foot strike. It sucks but I know it'll keep me running in the long term. Anyway - long comment. I hear ya, feel ya, thanks for the great post.

Jenn said...

Yes Jill! Heaven forbid you post more than once a week! I am not one to talk.

Wise man Ron! I "liked" you.

Jill, I honestly could NOT BE HAPPIER that you are able to start marathon training again. 35 years of running behind you, halted by what may have been feared to be "the end" and now you're back about to start doing what you LOVE once again!!! You should post your plan! I would love to see it!

Super Congrats to Ryan. I KNOW how proud you are here. I almost cried for joy thinking of you crying for joy because I know too well that amazing feeling of watching your child work hard and accomplish something important to them!!!

I won't pry with your daughter Jill. Know I am thinking of you and her. Blogs can wait. Family SO much more important.

Back at ya! LOVE being able to say RUN STRONG MY FRIEND and know you finally can!

Mark said...

Super post!! Your perseverance is awesome! No wonder you are such an exceptional runner! Congrats to Ryan!

See.Kate.Run said...

What a great post!! I suffered from tendinitis that developed during a half marathon- it lasted from January 09 to the end of 2010. Not being free to do what I liked in my body felt like a prison. I am so exhilarated for you. You are one determined woman! Congrats on being cleared for marathon! Amazing! :D

19:15 is SO fast! Congratulations to Ryan!
Sorry to hear that things are rough right now for your daughter. Sending good energy to you and your daughter.

Johann said...

Super stuff Jill! Really great post with fantastic info. I feel so grateful that I have never gone through anything like this. Well done to Ryan! That is very good! All the best with your daughter and life in general. We get out stronger and wiser each time. Take care my friend.

Ulyana said...

Pardon my french, my holy "sh*t. Your Ron is my Ron. HAHA! He also read my blog and also helped me out a lot by pointing me in the right direction. I'm so glad that you stuck to your guns and didn't get an unnecessary surgery. I'm so glad your are on the mend.

We need to thank Ron once more.

And I hope that whatever is happening with your daughter resolves itself fast. I know you must ache.

(Oh, and thank you so much for reading my blog. You don't even know how much it means to me).

Kate said...

Another marathon! :) I can only imagine how happy you are to finally be out of that tunnel. I'll definitely check out Ron's blog and articles.

You're right, building back up to anywhere near where you were is going to be a whole new experience...but you get to experience it!! Just remember to be happy THAT you are able to NOW, even if you get frustrated with the difference from what you were able to do THEN.

Congratulations to your son! I totally get your tears of joy. The first time I saw my oldest compete in a XC meet, it absolutely brought me to tears. I'd never seen him work so hard at anything. I hope this are better soon for your daughter as well. It's so much easier to go through pain yourself than to watch someone you love hurt.

P.S. Of course you knew I hadn't read your blog, bc if I HAD I would've commented. You know I always have something to say! :)

Aimee said...

JILL....YAY for being given the green light! I am soooo happy for you! That is just awesome!
So....when are we going running? :)

Teamarcia said...

Hallelujiah sister! So happy you've gotten to the bottom of the heel mystery. Thank you for sharing your wise words. This is precisely why I haven't gone to my sports chiro...he's helped me in the past but is not a runner. I know there's something mechanical I'm doing wrong.

WOOT for Ryan! So awesome. I know how proud you are. Well earned Mr. Sophomore varsity--wow!

Irene said...

Yay! Marathon training!!!! PERSEVERE!!!!

Anonymous said...

YAY, Jill, YAY!!! I totally agree with all the reasons for the heel, makes so much sense!!!!!!! Love green.. go green!!!!! Geez we need to plan a run together!

Amanda - RunToTheFinish said...

if you could see my happy dance, i would do it for you right's pretty good I promise.

I am currently frustrated with a lack of answers about my own sickness. I understand doctors can't know everything...but sometimes it seems like they have one generic answer for everything and are too busy to look for other causes or solutions. I'm so glad you have found someone who is paying attention and helping!!!!

GZ said...

45 comments Jill? Sheesh!

Stoked you are moving pain free. So - when do we get to see the training plan?

ajh said...

Yeah! I know you've been wanting to do a marathon forever again. I feel your pain with your daughter. I hope it works out. When our children hurt we hurt big time.

pensive said...

Thank you so much for this post. Really.

Kathleen said...

I am glad to hear that you are back doing the thing you love.
Congrats to your son.
I hope things with your daughter improve soon.

Glenn Jones said...

It's the difficult stuff that we remember, right? Now, HTFU Jill!

Jess @ Blonde Ponytail said...

I felt like this first part was written for me as I begin my struggles with PF. But, moving on...I'm SO HAPPY you are beginnning marathon training and that your summer has been so rewarding. You continue to amaze me!

Molly said...

I hope everything is okay with your daughter.....

wow, oh wow, I can't believe you started marathon training!!!!! I know you've been waiting for that green light, I'm so happy for you that it's now lit!!!

Anne said...

Family should always come first, Jill, especially before blogging :-). This is a great post, as I am someone who also spent years believing "rest" meant a few weeks off and not months as the doctor prescribed.

The Green Girl said...

Oh, Jill, I've waited so long to hear these words from you. ::huge huge hugs::

I truly admire your tenacity.

Noel DLP said...

Hi Jill, I read this NY times article regarding sports medicine last night which I found interesting. I don't know if linking works here but I'm going to try

Noel DLP said...

BabyWeightMyFatAss said...

boo i never posted when this first went up but um yay you are are running again!!!

and sorry about the kid stuff :(

2 Slow 4 Boston said...

Nice write up Jill. It was a good read. I will refer anyone I know with foot pain to your blog.

Anonymous said...

Really good post! Most of my "recovery" has been based on the fact that both my doctors (NP and Podiatrist) are runners. My podiatrist is an IM finisher. I knew I was in good hands. Yes, some of the "recovery" is a band-aid, but luckily I got a grasp on it early and was able to work it along side changing my stride. So far, so good. Fingers crossed. I am happy to hear you are back in the game!

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