How Plantar Fasciitis Is Helping Me Become A Better Coach – Movement Labs

How Plantar Fasciitis Is Helping Me Become A Better Coach

I’ve nursed quite a few injuries/health issues in the 13 years that I’ve been a runner.  My personal list includes metatarsal stress fractures, a busted up ankle, peroneal tendonitis, IT-band issues, and anemia.  Although I should say, in running’s defense, only the ankle and IT band can be blamed on running – the others, not so much.  But I have never – never, ever, ever, ever, EVER encountered anything as fussy and frustrating as this current battle with my plantar fascia.  [I’ll be discussing the details of how I’ve been treating my PF in an upcoming post.]

If I were my own client, I would have the following conversation with myself:

Coach Me: How does it hurt (ache, stabbing pain, etc.)?
Client Me: Usually it aches.  But sometimes it feels like a pulling, or even a burning.
Coach Me: Is it binary, like, it hurts, or it doesn’t?
Client Me: No way.  There are a LOT of in-betweens.
Coach Me:
 So when does it hurt the most?
Client Me: Erm…Sometimes it’s sore in the morning (but sometimes it’s not)…and in the evening, too.  And sometimes (but not always) in the afternoon..
Coach Me (looking for a pattern): How about in relation to a specific activity?
Client Me:  Swimming doesn’t hurt.  Sitting doesn’t hurt.  Most of the time, walking in supportive shoes doesn’t hurt.
Coach Me: OK.  So it hurts at all OTHER times?  Like, when you’re standing on it and don’t have shoes on?
Client Me: Well, no, not exactly.  Sometimes I’m doing that, and it doesn’t bother me at all.  Yesterday I wore my Vibrams and walked all the way to the grocery store and back – no pain at all!
Coach Me (thinking this might mean some improvement): How about for the rest of the day?
Client Me: Well, after I’d been home for awhile and was puttering around, it hurt again.  Kind of a lot.  But then less again in the evening.
Coach Me (still looking for a pattern): So, talk me through your day, and tell me how much it hurts at different times.
Client Me: OK. Let’s take yesterday, for example: I get out of bed and it feels good for a few steps.  But while I’m making breakfast, it starts to hurt again.  After breakfast, it’s OK, but not great, while I get cleaned up and ready for my day.  I work at my desk for awhile, with breaks to get water or lunch, and use the restroom.  Sometimes it hurts when I stand, sometimes it doesn’t.  I get changed for the gym and put on my supportive sneakers.  When I’m wearing those, it doesn’t hurt.  I do my workout – Body Pump or Spin, and that’s fine.  When I’m done and take my shoes off, sometimes it hurts and sometimes it doesn’t.  But that was just yesterday.  On other days, it hurts more/less at different times.
Coach Me (interrupting): Does it hurt more after a certain kind of workout?
Client Me: No, not really. For awhile, I thought Spin was pretty good and maybe made it feel better, but last night I spun, and afterward it hurt.
Coach Me: Oooook….
Client Me: Yoga sometimes hurts, because I’m in bare feet.
Coach Me: Do certain poses hurt more than others?
Client Me: No?  Sometimes it hurts, and sometimes it doesn’t.  *shrug*
Coach Me: How about running?  You raced on Sunday.  How was that?
Client Me: Well, it didn’t hurt while I was running.  For the rest of the day on Sunday, it was OK – like it’s been.  Maybe it hurt a little more on Monday, but I’m not sure.  I may have been imagining that, and Tuesday was definitely average, like it was before the race.
Coach Me (going for a different approach): Overall, does it hurt more than it did two weeks ago?
Client Me: It’s about the same…I think.  I mean, when I’m standing, it still doesn’t hurt a little bit of the time, it sort of hurts/I can feel it most of the time, and it hurts a lot occasionally.
Coach Me (one final attempt): So, on a scale of 0 (none) to 10 (childbirth), how much does it hurt?
Client Me: That’s really hard to say.  Right now, I’m sitting down.  So, 0. [I can be a bit of a smart aleck sometimes.]
Coach Me: How about…on average.
Client Me: I can’t answer that question. Every step is different.

Three weeks ago, if I had this conversation with a client, I would hang up the phone and let out an exasperated, “ARGGGGHH!!!”  I’d also probably figure that she was being evasive: Perhaps she was running when she wasn’t supposed to, or not sticking to her icing/stretching/rolling regimen, or not paying close enough attention to her body to notice trends/patterns.  Because, really – most injuries have a pattern.  They hurt in certain ways, or at certain times, or in relation to certain activities – not this willy-nilly business that the client above describes.

But what’s humbling is that, in this case, I’m the client.  I know that I’m stretching, and icing.  I know the workouts I’m doing.  I know that I’m not changing my footfall (at least, I’m trying not to).  As people go, I’m pretty in tune with my body (at least, I have been for all my other injuries), and I trust my assessments of myself.  So this on-again/off-again, apparently pattern-less discomfort is driving me bananas.  My Mom innocently asked me if my plantar fasciitis was doing “better” the other day, and I almost threw a frustrated fit.  “I think it’s about the same.  I don’t think it’s worse.  But…*ouch that step just hurt* …I just don’t know.”

This is an important caution and reminder for me as a coach: Sometimes, an injury is fickle, and it’s not necessarily the athlete’s fault.  And while I certainly can coach people through injuries/chronice health issues that I’ve never had (thank goodness!), sometimes there really is nothing like experience.

I’m not even talking about knowing a cure or treatment – there are plenty of references for that.  I’m mostly talking about understanding a client’s experience.  For example, everything I read about plantar fasciitis says, “It usually hurts the most when the individual first wakes up, and after sitting for long periods.”  Before PF, I would expect a sufferer’s experience to approximately mimic this.  But in reality, I haven’t been able to reliably correlate my discomfort to these times/activities.  This doesn’t mean I don’t have PF, and it doesn’t mean I’m lying – it just means that PF and I, and our experience together, are a little weird.

So I am reminded that, when faced with an athlete going through something I’m struggling to understand, I need to use my support network.  It’s OK – even good – for me to ask for help.  And ultimately, being aware of my own limits makes me a better coach, not a worse one.

Running friends, fill in this blank:  I am an expert on (insert injury here).

Anyone recently sucked it up and sought advice, even when you thought you knew ‘the answer’?  Did it pay off?

P.S. If you ever need someone to talk to about anything mentioned in that first paragraph, go right ahead and let me know. I can’t promise a miracle cure, but I can promise to share what insight I do have, and provide some reassurance and a sympathetic ear…

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  1. Kristen L March 15, 2013 at 2:23 am - Reply

    I haven’t had any big running related injuries to date — little IT and glute tightness at times, but stretching and rest made it go away fairly quickly. My main injuries have been ligament tears in my knees and shoulder, so I know a lot about those.

    Have you found some other people to talk to about your PF for more advice?

    • Holly KN March 15, 2013 at 10:18 am - Reply

      Ligament tears…*shudder*. In your shoulders AND your knees…What sport were you playing, rugby?? 😉

      I’ve been lucky enough to access a bunch of different PF-related resources, from both individuals and literature. For better or worse, lots of people have done battle with it. 🙂 Although I will admit that I haven’t actually brought it in to see a doctor, because I’m just not convinced that they’ll be able to much for me at the moment. I’m compiling a “treatment” post now…

  2. sarrilly March 15, 2013 at 3:16 am - Reply

    Sad to hear about the frustrating nature of your PF (and the pain!) but happy to hear that there’s a plus side 🙂

    And you definitely made me LOL here in my empty classroom reading about how you interrupt yourself in imaginary conversations 😀 Miss you!

    • Holly KN March 15, 2013 at 10:19 am - Reply

      My head is a crazy place to be sometimes. If only I had…wait for it…A SMALL BOWL, I think that would fix the problem. 😉

  3. Cecilia @mommiesrun March 15, 2013 at 5:33 am - Reply

    First of all, I’m so sorry your PF is still bothering you. Injuries are the devil. Second of all I have questions about my metatarsal stress fracture. Realistically, when am I going to get to run again?! I’ve been in the boot for 4 weeks now. There is a half on 4/13 that I want to run but I’m scared to register for it 🙁

    • Holly KN March 15, 2013 at 10:48 am - Reply

      Hahaha. YES, the devil. I think we need Cait the Arty Runnerchick to draw us some kind of injury/devil image, no? 🙂

      Running: Definitely maybe, but it’s probably not smart? :-/ I suspect you’ll be back to running by then, but 13 miles is pretty far without much run-specific training on a foot you might not be 100% confident in, yet. Is there a shorter option, or the opportunity to volunteer instead??

      • Cecilia @MommiesRUn March 16, 2013 at 5:04 am - Reply

        I think it’s just the half. I know in my heart you are right but I’m just going insane! I think we definitely need an injury/devil image 🙂

  4. Kristen @ Happy Running Mama March 15, 2013 at 5:56 am - Reply

    I’d love to hear your experience with IT band issues. I had IT problems once about 8 years ago and it kept me from running my marathon. I took a long recovery approach and haven’t had an issue since then. Until last week. I ran a hard 20 mile long run that turned out to be at my goal marathon pace. My knee started hurting at mile 15 and I’m pretty sure it was my IT band. Now I’m religiously stretching, foam rolling and icing. (Although by “religiously”, I mean as often as a mom of three kids can find any time to do something for herself!) I’m worried about my Boston training. I scaled this week waaay back but need to run another 20 next week.

    What is the best method you have found for dealing with IT issues and keeping them at bay? Stretching? Foam rolling? Icing? Or, dare I say, rest???

    I hope you get some relief to your PF issue. It sounds just awful and so frustrating!

    • Holly KN March 15, 2013 at 11:14 am - Reply

      You know, the IT band can be really finicky, too – but I’ve always found that if I pay attention when it starts to tweak, I can usually keep any serious issues at bay.

      I do think that everyone is a bit different, but for me, the three keys are: Tennis ball into my hip, Foam roller and Compression tights/capris. I love stretching, and spend a lot of time on my hips – but generally didn’t find much correlation between ANY stretch I could find and loosening up the IT band, believe it or not. Instead, digging that tennis ball into my hip helped keep things loose. And obviously, foam rolling up and down my IT band (when I started, I could hardly put any weight on it – now I stack my legs and roll my whole lower-trunk weight). Finally – I swear by CW-X bottoms. When my IT band is getting tweaky, I pull out the capris (even in the tropics) – I think they just help keep everything compressed, in line, and stable. I extra-like them because they don’t just mask the irritation, so that it hurts later when I take them off – they really just help keep things in line so there’s less irritation (<-- not scientifically proven, just my feeling). Plus, I think they help my legs in other ways, too. They're not cheap, but in my mind, they are SO worth it. Besides...aren't you due for a replacement pair of tights anyway? 🙂 All that said, my experience has shown that once it genuinely starts hurting, repeatedly and increasingly, BACK OFF right away (like, stop your run) - because once that sucker gets really irritated - THAT is when longer recovery and time off come into play (for me, at least). Hope you find the magic mix that will keep things relaxed and feeling good as you move through your last heavy training weeks. *fingers crossed* And feel free to send me a message if you want to chat about it more...

      • Kristen @ Happy Running Mama March 17, 2013 at 5:48 am - Reply

        Thanks so much for your response, Holly, and also for the email…you are so right that the comments get buried and it is hard to remember to come back and check. 🙂

        I have been massaging a tennis ball into my hip, per your suggestion, today. I’m not sure if I’m doing it in the right place but I must be doing some good because EVERYWHERE that I put it, I am sore! Ugh. I feel like a tight mess right now. I am going to keep at it, though, and hope that it helps.

        I went to two different stores today looking for the compression tights — I never thought about using compression tights to hold my IT band in place. What a great suggestion! The stores are out of my size but I’m ordering some online that will be here next week. I was thinking they would be great for my 15k race tomorrow but, oh well. They’ll help me out in the remainder of my Boston training and going forward. And, YES, I am due for a pair of replacement tights! Ha!!

        I’ll keep at the stretching and icing, too, but have to agree with you that the stretching doesn’t seem to help much once it is already hurting. Thanks again for your advice!

        • Holly KN March 17, 2013 at 9:19 am - Reply

          If it hurts, you’re doing it right. 🙂

          Doh! Sorry you couldn’t find tights yesterday – they would’ve been great to have if you’re racing tomorrow. But hopefully they’ll help. [And even if they don’t do anything for your IT band – although I suspect they’ll help – you’ll fall in love with them for their other benefits. :)] If you see this before then, remember to back off the pace if it hurts…I do think (for me) speed plays an issue. And, weirdly, as much as overall stretching doesn’t seem to do much – if I feel a little twinge while I’m running, stop, and stretch for 15 seconds, I often found I was good for a few more miles. [Or maybe this was just superstition… 🙂 ]

          Have you considered going for a sports massage/ART/etc? I was too cheap to go that route before, but in retrospect think that was a silly decision. Also might be worthwhile. Ask around the running community in your area for someone who does good (painful) things for athletes…

  5. Jules March 15, 2013 at 8:30 am - Reply

    Sorry to hear about your PF issues. 🙁 *sends positive thoughts your way*

    On a separate note, I’m now beginning to think I have PF. I thought it was my shoes so I got new ones but I’m beginning to feel an ache in my feet when I run. Or maybe I’m just paranoid I don’t know. We’ll see.

    • Holly KN March 15, 2013 at 10:31 am - Reply

      Oh, dear…noooooo!! Where, exactly, are you hurting? Oh! New post! Let me wander over and read it before I ask sixty zillion questions… 🙂

      • Jules March 18, 2013 at 8:49 am - Reply

        Around the arch, when running only. Haven’t done stretches or f-rolling in a while so I made sure to do that this weekend. Also used the tennis ball tip of yours today so hopefully that’ll help!! Off to read your new post now. 🙂

        • Holly KN March 18, 2013 at 1:12 pm - Reply

          *Insert all caveats about not being your physician* BUT – if it’s legitimately in your arch, it’s significantly LESS likely to be PF (which usually manifests at the VERY VERY back of the arch/front of your heel). I’m guessing you have high arches, and your mileage is creeping up. That’s a recipe for sore/tired arches. Good news is, if they aren’t too bad, they’re probably pretty easy to save. My *insert caveat* suggestions would be: (1) Roll on tennis ball (or frozen water bottle, if that feels better). (2) Perhaps try some Superfeet inserts. Superfeet are over-the-counter orthotics that come in a few different shapes/types for different kinds of feet. A local running store will probably have them (Superfeet does have a UK presence, I checked!). If you have high arches, you’ll probably want the green ones – but consult a trusted running store staff member. They may even have a sample you can try. I used these for a few seasons when my mileage increased faster than me feet got stronger and I was having arch achiness. (3) Strengthen your feet. Briefly, I recommend doing this daily (should take you less than 10 minutes):
          1-2 sets of (point/flex toes x 15)
          1-2 sets of (point toes left/point toes right x 10) <--yes, this feels weird Ankle rolls, 5-10 in each direction (SLOWLY, hitting every "number" on the imaginary clock) Towel Squinch (stand on a thin towel and curl/straighten your toes to pull the towel in to you) x 1-2 minutes Anyway, just my two (ten?) cents. Hope those feet are feeling as good as new really soon! 🙂

  6. Amy Z March 15, 2013 at 9:02 am - Reply

    I think you are a great coach already! Heck, your comments on my blog are fantastic.
    I haven’t really had any major running problems or injuries aside from soreness after upping the miles too much, too soon (and I totally blame myself). But I am scared to death to have something that might sideline me for a while in the middle of a good running spell. I know this sounds like a fad, but many people swear by tape (I actually forget what the ‘real’ name for it is) for PF. Do you know anyone in Singapore who does it? Running stores are even selling it now; apparently ‘experts’ no longer need to do it?

    • Holly KN March 15, 2013 at 10:55 am - Reply

      Thanks, Amy! Glad I have a useful tidbit to offer here and there. [HA! ‘Tidbit’. As if anything I write is a ‘tidbit’…brevity is not my strong suit. :)]

      You know, I haven’t tried PhysioTape/Kinesiology Taping – but it might be worth investigating. There are places that sell it around here, and actually I’ve seen quite a few instructional videos/pictures on how to tape a PF. I just have mixed feelings about giving it artificial support so I can run, versus resting to let it strengthen and heal. Fine line…

    • Holly KN March 15, 2013 at 10:57 am - Reply

      PS Don’t run scared. Run smart. If/when something happens, you’ll deal with it. And while that’s not always fun, it can help you come back a stronger – and more experienced – runner. 🙂

  7. Jean March 15, 2013 at 2:40 pm - Reply

    I am certainly not an expert, but I know what a cuboid stress fracture feels like! THAT was an incredibly confusing pain because although I could define the kind of pain (stabbing, whenever I put weight on any part of the foot), I couldn’t figure out WHERE it hurt. I only knew that I could not stand on it, and that the part of my foot that was injured was the only part of the foot that didn’t hurt (very much). In the week or so before I finally got my foot checked out (stubborn!), I was getting around by walking entirely on the very outside part of my foot, which didn’t hurt all that much, yet that’s where the stress fracture was. I couldn’t believe it when I found out! The body’s a strange thing.

    I’m sorry to hear you’re still having issues; PF sounds so incredibly frustrating! Maybe it’ll inspire you to find the magic cure? That’s a totally realistic expectation, right?

    • Holly KN March 16, 2013 at 12:20 pm - Reply

      Kudos to you. You just taught me what a cuboid stress fracture was (I had to go look it up). 1 Point for Jeano!! [Although I’m sorry you had to live through it. It sounds kinda awful.]

      I’m working on the magic cure. Currently testing: Singing Adele, while rolling on frozen water bottle, and playing with website. If it works, I’m gonna be rich… 🙂

  8. […] pretty mad at my foot.  I expressed some of my recent frustrations with this particular injury in a conversation with my Coach Self.  But I didn’t say a lot about what we (Coach Self and Runner Self) are doing to fix things. […]

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