Plantar Fasciitis
 

Hi. Back before Christmas I started developing pain while walking/standing. Long story short, its plantar fasciitis. Saw the family doc who referred me to an ortho & a podiatrist. Tried prescription steroids, other non-steroidal anti-inflamitories, shoe inserts (prescription & OTC, various exercises & stretching, night time boot among remedies. I’ve been mountain biking a few times and that doesn’t seem to bother it much but going out on the road bike (including one that was recently professionally fitted) really seems to agitate the PF. Even after a short 12-15 mile ride, my foot is in in some pretty bad pain for a couple nights after. I’ve tried wearing regular sneakers w/ clips and some clipless & regular biking shoes and still seems to be really agitated. This will be addressed when I see the doc again but he’s not a cyclist and said I may not be able to ride much which I’m not too happy about. Anyone have experience with PF and cycling? I know I’m not the first. Pain is primarily at the base of my heel and across the middle of my foot (left foot, right one is wine). Any advice is appreciated. So far most of what I've tired hasn't helped much.

I first had PF years ago, and will get very rare flare ups here and again. But back then in was not a bike guy, just a college student, if memory serves it all started due to the popularity of roller blades being an easy form of campus transport.

Results vary, but my only relief came after long term stretching, strengthening exercises and massage. Don't keep changing things, search the internet for stretches and exercises and stick with it. Takes a while to get relief. It's a really crappy condition to have. Sometimes you need to break down the scar tissue to make progress and that hurts like a mother...

I was plagued by that for a while. Did the night boot and all. What worked for me was going barefoot as much as possible and wearing shoes with little or no drop from heel to toe.

If that doesn't help then maybe move your cleats back (toward heel) a little to reduce the stress on that tendon when cycling.

What pedal system are you using? I switched to a 3 bolt system because of foot pain and have been much happier.

I suffered from PF for a long time. Tried all the usual treatments with no long term success. Finally went for shockwave therapy and it worked. I haven't had any problems for the last 15 years or so. Might be worth looking into.

I had my appointment last week for my foot pain. I didn't wait for my pain to get out of hand. PF for me too. My podiatrist suggested I never go barefoot, wear Crocs. Especially in the middle of the night when you get up to go to the bathroom. I bought Crocs that day and have had them on religiously. Rode tonight with no PF pain. I highly recommend Crocs.

Its worse at times than others, mainly if I've been on my feet more. The first foot doc gave me similar exercises to the second so there has been consistancy (switched for insurance & non-medical reasons.) Stretching I know is largely the key most of the time, but I feel it gives temporary & limited success. Walking around on well padded floor with no shoes seems to help. Also walking around barefoot or in socks outside in the garage, driveway, etc. helps make it feel a little better (like walking around on a cold pack, which I use as well at times. I'm going back to see him on Thursday and we'll see what he wants to do next.

I bought clipless at the end of the season when a local store was going out of business. Its a Look Keo system. When I had a fitting done at one of my regular shops about a month ago he set them up. Both he and the docs told me to hold off on them and use sparingly until we seem to get the upper hand on the PF. I plan on taking it them and the bike with me to my appt Thursday and see if we can figure out a direction. The bulk of my riding bas just been on smaller Wellgo style road pedals & clips. What seems to bother me the least is on my MTB where I just typically run platform pedals and normal sneakers.

What is shockwave therapy? That not the same as electroshock is it?

Stretching the calf and Achilles is important. Besides the night boot an effective stretch invokes a rolled up towel (roll it into a 2-3 inch tube). Put the towel on the edge of a step. Step with your bare foot on the towel and keep it under your toes and the ball of your foot. Hold on for balance and do a toe rise for two seconds. Then lower your heel to really stretch for three seconds. For this alternating raise and lowering for two reps.

I have a case that's been off and on for years. Seemed to start up every winter and disappear every summer. Thought I nailed it down to the boots I would stand in all day at cross races. So I didn't wear those boots this year unless it was super muddy. Still bad. Even worse right now....then figured I wear my mtb shoes during cross and have still been riding my cross bike this spring. Guessing maybe that's the source.

My employee has been a top end racer for years and before that she was a triathlete. Had PF for ages. Off and on. Tried everything. Ended up doing something that just really flared up. Ended up in a boot for 6 weeks all the time. After that - she's been 100% fine. Been a year now.

I developed moderate PF several years ago and what worked for me was MBT walking shoes. While they have a rocker sole they are nothing like the ill-fated Sketchers of the time which looked similar but functioned differently and were way over hyped as some sort of magic full body fitness miracle. The sole under the heel of the MBT is softer than the sole under the arch and toes providing a bit of a fulcrum under the arch. This provides a gentle heel down stretch with each step. I wore them as my general walking shoes and the pain improved within a couple of days and disappeared within a week and stayed away for extended periods, even after I quit wearing the shoes.

These shoes got a bad rep as some people were using them as running shoes and expecting some kind of miracle cure for everything that ails them. DON'T DO IT. The MBTs take some time to get used to and it would be easy to twist an ankle running in them. Be a bit careful going down stairs at first as well as it is really a different feel. If you treat these as a theraputic shoe for PF, they are great. An all around athletic shoe they are not. I keep mine in the closet in case I get a flare up.


As far as bike fit, I see riders get PF flare ups from too much ankling on the stroke and/or having the seat so high that they cannot keep their foot relatively level at the bottom of the stroke. Toes down might feel faster, but it really doesn't gain anything and sets you up for tendon/ligament problems.

Have you been told to stretch early and often? I had a very bad case of PF several years ago. The first ortho I saw gave me a pamphlet that I could have found on my own on the Internet. I got a second opinion from another ortho when the stretches shown in the materials didn't help all that much.

This guy told me too important things:

1. In the morning, stretch your calves before your feet hit the floor to lessen morning pain. At least three times for 15 seconds.

2. It may not be enough to do the prescribed stretches two, three, four, five or even six times/day. Since I have a "desk job," he suggested that I stretch out my leg under my desk every time I got an email or the phone rang.

Both suggestions helped a whole bunch.

GravelMN: The first ortho recommended some New Balance shoes but they made the condition worse so we didn't go that route. The MBT's havne't been recommended but I'll look into them.

Both the orth & pediatrist recommended similar stretches, similar to what a runner would do as far as calf stretching. The pediatrist also recommended something similar to what StanSeven said about standing on stairs. That is the main one I've been doing (though the pediatrist advised only to do a heel drop and not raise them up above flat). I've felt it pulling on my calves but not on my feet as he said I should, but after I do about 5-6 reps holding from about 15-30 seconds (gradually increasing) I do feel better, but that's only temporary. I will admit I've not been doing those as often as I should (I know: the more exercising I do the more it will help and this isn't something that will fix itself overnight). I do stretch it out often at work though at my desk.

Another thing the ped recommended is sit in a chair, wrap a towl around the ball of my foot ang gently pull and do several reps... basically a modified calf stretch sitting down. I do that in the evening when watching tv or the little down time I get.

Not sure how common this is with PF (I know each person's conditon and situation is a little different) but my leet tends to get worse in the evenings, often in direct relation as to how much I'v been on my feet for the day. Usually doesn't bother me when I wake up.

I had trouble with my left knee starting to hurt pretty bad (pain just below the knee cap) just after about 7-8 miles into a normal 22 mile route late in the season last year, before the foot problems started up. That was traced back to a seat that had been slowly slipping. I could limp home, grab another bike and complete the whole route without problems. The LBS noted I was riding more with my toes pointed down at the time too and we adjusted the bike an I paid closer attention to my foot angle at the time. Knee problems went away after. Currently when I ride (I'm only gong out 12-15 miles at a time right now) I can feel pressure on the inside of my foot, between the arch & my heel. That's with regular tennis shoes. My heel tends to start getting really sore within 24 hours after that, though I did a 14 miler Monday night and it didn't seem too bad last night (worse than usual but not as bad as when I rode last week.) I'm thinking that switching to the clipless might help this a little since I wouldn't be able to angle my foot as much? Make sense? I do appreciate the feedback and suggestions.

Here's also a few things I'm going to look into and discuss with the ped tomorrow when I see him:
1. MTB shoes (I do need new shoes period)
2. show him my cycling shoes and see what he thinks (previously he had advised to not use them until this is under control, but I'm wondering if they might offer more support and keep my foot in a better position)
3. obviously work more on the stretching & exercises. I forgot to mention I've been using a cold pack when its bad and will probably increase the use of that.
4. I've bene taking alot of ibuprofen (Naproxen and other prescription anti-anflamitories other than the steroids havne't helped). I also saw another thread from about a year ago where someone recommended Omega-3s : Omega-3s in very high doses have a powerful anti-inflammatory over the long term. You have to ramp up slowly, but I do 10 grams fish oil a day and it keeps my long term injuries in check, both functionally and pain wise. (that info was from this thread: http://www.bikeforums.net/fifty-plus...fasciitis.html)

2 things worked for me.

1. Twice a day stick your foot in a container of ice water (ice included). After a while you'll be able to keep it in the water for 5-15 minutes at a time. The longer the better.

2. After the icing I would take a baseball (hardball) and roll it around with the heal of my foot. Do this as long as you like. For me, the longer I did it the more it helped (massage effect).

I would do these both while I'm sitting at the computer each day so it was really nothing that would distract you from your daily routine.

I have had it off and on over my life time.
It is a chronic & painful thing but is easily delt with if you keep at it..
Ice & Stretch..also buy a boot or sock to wear to bed. Google the stratmore sock? something like that I have used it and I bought a hard plastic boot the wear to bed as well. This will improve the PF in a matter of days..stretch calf daily many times a day just keep at it. Also cold press ice the heal...in 2 weeks time u should be 100% better

i've been battling PF since october 2013, and cycling and skiing are about the only things I can do pain free, since the foot/arch is not flexing. i always wear cycling shoes, with rigid custom orthotics.
if you wear non-cycling shoes, they will flex, and put pressure on the attachment of the PF as the arch moves.
f you wear cycling shoes with non-rigid insoles, the same thing will happen, but to a lesser degree.
The mechanics of the irritation and pain should be pretty consistent from person to person, but the resolution is different for everyone.

to be clear, I have tried shockwave therapy, boot for 9 months, multiple custom orthotics, cortisone injections, iontopheresis, soft tissue work, ice, etc, and these are my own personal realizations. hopefully they help at least a little bit.

and not to scare you or anyone else, i have a genetic connective tissue disorder that makes these things heal up far worse than normal folks (Ehlers Danlos - hypermobility type). For the vast majority of people, custom orthotics, stretching, rest, and ice are all that is needed.

I had the same issues......I actually ruptured mine playing football barefoot with other grown men, oops. That day prior to football I walked 18 holes golfing on a very hilly course, so apparently that is what did me in. Anyway, I wore the boot, did the ball (tennis or baseball) exercises, and the most helpful thing was getting several pairs of the Dr. Sholls inserts specifically for PF. Now, this took about 6 months to totally heel, and all of my shoes have the inserts in them and I am problem free. Ever since I purchased a stiff carbon sole cycling shoe with SPD-SL pedals, I have no pain EVER cycling. Before the cycling shoes I had the cheapo "cage" pedals and at times my PF would hurt bad.

best advice, good pedals with a wide platform, stiff carbon sole shoes that fit well, and properly fit shoes and pedals.......past that, ride away pain free!!!!!

I've also tried a gold ball (all I had available) and think I might have overdone that a little as it was pretty tender after do that a few times. I went for a 14 mile ride Monday night and a 15 miler tonight. Foot is sore, but not near as bad as what I went through last week. I immediately started in with the calf stretches & dropping my heels on the stairs and I did start noticing it pulling across the bottom of my feet (something not felt before.) Will really be increasing the stretching alot too.

My road shoes are Louis Garneau Ergo Air Comp 2 Road Shoes I bought when the closest Performance Bicycle closed last fall. Haven't had much chance to try them but I'll put the clipless pedals on a bike and play with them and see how I feel with them.

Had it pretty bad about a decade ago. Brought on by rock climbing almost every weekend and the stress placed on the foot by too much time with all the weight on the tips of the toes.

getting up in the morning was a 10 minute process.

Got religion about the stretching and put Superfeet insoles in every pair of shoes I have except the cycling cleats. A really supportive orthotic will help. Out of the non professionally fitted ones the Supperfeet seem to be about the only ones that will do any good. Almost all of them are far too soft to do anything. I'd try them first and if that doesn't help go see a podiatrist about an orthotic.

No matter what it's a long recovery process, especially if you do something to really aggravate it every weekend like I did.



One thought, make sure your cleats are as far back as you can get them so you take the stress off the arch of the foot.

Try freezing a 12-16 ounce water bottles and then roll under foot. That and a Medrol dose-pak worked for me. Sometimes PF starts overnight and stops overnight for me. I do take Mobic 15mg (prescription) for arthritis. It is once a day equivalent to ibuprofen, comes in generic and is not expensive.

Stretching, ice, and cross training type shoes with stiff soles and soft inserts did the trick for me. Funny, but riding never bothered me. Even on days that it hurt to walk, it felt fine to ride. Good fitting basic Shimano road shoes with Look pedals.

Been there.
The PF is part of the calf muscle. Can't emphasize stretching enough.
You'll have to experiment with different shoes/no shoes.
I use Specialized Blue inserts in my cycling shoes.
I wear Keen Targhee shoes.
I live in Florida, so I do a lot of barefoot.

These sandals are cheap and have great arch support:

Mens Eurosport Sandals | Essential Collection | Okabashi Shoes

Stretch that calf and keep it stretched, without stressing it, of course.
Good luck.

S

Here's my story. It is different from most but we are all different. I was an athlete from the get go and played basketball at the collegiate level. I continued playing until I got PF sometime in my late 30s. I had to quit playing BB so I turned to cycling. I got hooked, found a vintage bike, fixed it up and started doing longer rides. I could not shake the PF though. My riding buddies were constantly needling me because I would not go clipless. I stayed with clips and straps because the stiff soled cycling shoes seemed to make the PF worse.(also, you ride vintage you need to look vintage) All the while I was still wearing basketball shoes and x trainers. I still could not shake the PF. When the wife turned 40 she had a mid life crisis and became a runner. After about a year she wanted me to do some 5 and 10Ks with her. But I had PF how was I going to do that? I was rolling with golf balls, etc. but still could not shake it. I signed up for an event anyway and had to start training. My issue is I have very strong, tight, connective tissue around my joints throughout the body. So I did lots of reading and research. Natural running, barefoot running, blah, blah, blah, etc. I decided that I had to get the feet, arches, achilles, etc. stretched out, in shape and keep them that way. All of those years of wearing heavily supported court shoes had taken their toll. My feet were weak and not in shape. I ordered a pair of "transition" shoes that people use in the transition to barefoot/natural running. I begin to run with them. I had read that the first week or two is filled with pain as the foot adapts and gets in shape. That is an understatement! All I could manage was a couple of miles before my feet were hurting so bad I could hardly walk. I was ready to take the shoes back but a funny thing happened. The feet would hurt during the run and after, but when I woke up the next morning they would feel great! After about a week the pain came less and less. Eventually the pain disappeared replaced by feet that feel strong and more flexible. And the PF is gone, I think. I haven't tempted fate and returned to the BB court, but I do endurance events now such as centuries, tris, 1/2 and full marathons. The running stretches the achilles, plantar and feet. The Hammer Toes I had from the basketball years have just about straightened out. My gait is a lot better because the foot has to work. Bottom line is that all of the muscles in your body have to be worked out or atrophy will set in. The achilles tendon and foot are no exceptions. I switched out all of my shoes for those with little or no support. You still need shoes with cushioning, but not support.

Think about it this way. How many people will "hurt their backs," etc. doing yard work this spring? Yard work is not particularly hard. But if you are not used to it and your body is not ready for it, you are going to pull a muscle planting some flowers or pruning some bushes.

Freeze a 12 oz. can of Coke, Pepsi etc. Place on the floor and roll your arch back and forth over it while watching tv. You get the stretch others have mentioned and the soothing inflammation reducing effects of the cold. Good luck

Pretty much the same here.

Oh, and rest, too. Gotta give it time to heal.

Ice seemed to be the biggest thing - as another poster said, stick your feet in a bucket of ice water for 10-15 min. Warning: it'll hurt like HELL the first few times you do it.