Last weekend (would have been May 29 or 30th), my heel had been feeling good enough for a long enough time that I decided to run a quick 1.8 miles. I mostly wanted to see how it would react after the previous week had seen some pretty encouraging improvements. Would it be a set-back? Would it be no worse for wear? Would the foot continue to feel better over the next couple days even with the running?
Fortunately, what I found was that the 1.8 miles did not appear to be a set-back. However, I also iced my heel a decent amount immediately afterwards, and after a couple days also applied heat. In another 2-3 days I felt good enough to do another 1.8 miles, with similar results - the heel continued to feel better as a whole as time went on.
I was going to cancel my doctor appointment on the 1st, but I never thought about it on the Friday before, and with the holiday on Monday, I decided to keep the appointment, see what he had to say, and at least have the visit on record in the event this thing flared up again or remained persistent.
When I went to the doctor, a couple things came out of it:
1) He suggested to continue icing only, no heat.
2) He recommended the green Superfeet arch support. In the same conversation, he said he doesn't like custom orthotics, which I found strange because I know a couple people who have been sold orthotics (and neither of them found them to be useful). The doctor indicated that custom ones are meant to change your foot structure and alignment, whereas off-the-shelf ones are meant to support your foot as currently built. It should be noted that I was suspicious of his trying to sell me custom orthotics, as it was a podiatrist. It was refreshing to hear him say he doesn't like custom orthotics. Also, he didn't suggest always using the supports - he just said to use them when running.
3) He also mentioned that soft surfaces (like mowing the lawn!) are notorious for aggravating PF. Due to the lower resistance provided by the ground surface, it places more strain on the connective tissue that is inflammed when you have PF.
So, while I took everything he said above into consideration, I have been finding that application of heat is actually helpful. Plus, that coincides with everything you hear - ice at first (durign first 48 hours) to control inflammation, heat afterwards to stimulate blood flow and healing. I also decided that I'd only use the supports while I have this issue - once it is healed, I'll remove them. I just dont see the need to use arch supports when I've never needed them in the past, and I have a very very good idea of what caused my problem in the first place (and its something I can avoid).
Another thing I came across last week is a different take on icing. I can't seem to find the specific article (this one is similar, though), it seems that there is a recent trend in using more direct ice application as opposed to only use ice packs. The article I found last week specifically mentioned using direct ice until an area feels numb, and then removing the ice for a while to let things warm back up, and then repeating with ice. The general idea was that this direct ice was good for controlling inflammation that is near the skin surface (within 1 cm), because the amount of time that ice is in contact with skin is relatively low. However, if you have inflammation that is deeper (like in the knee), the slower icing effect of ice packs is better for that. So last week that is what I did - during the work day, I filled up a plastic bag with ice, put it in the freezer, and while sitting at my desk, I'd let me heel rest on the ice until it felt numb, then remove it, and then put it back on. After two days, the improvement was dramatically noticable. While the heel had been feeling better - now there were actually times where it didn't feel at all that there was a sprain (and I'm not talking about times when I was icing, or had just iced).
I also started using heat pads at night, in order to stimulate blood flow during a time when the body heals itself and when the heel is not under any strain. So, during the day when the tissue could be aggravated, it was ice. At night when there was no weight on it, it's been heat. So far that seems to be working rather well. Well enough that I'm going to do another 3 miles today, another 3 miles later this week, and hopefully should be ok with doing 5 this weekend.
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