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Carolyn’s Workout Diary: Bugger

MiNDFOOD associate editor Carolyn Enting faces her fear of needles to combat a running injury though it makes her break out in a sweat.

Carolyn’s Workout Diary: Bugger

It’s been nearly three weeks since my last fitness blog and there are several reasons for that.

First, I got the dreaded lurgy. Then there was New Zealand Fashion Week (which demands long hours), so I was unable to train for 10 days.

The thought didn’t panic me, however, because I knew I couldn’t lose my cardiovascular fitness in that time. Plus my feet had been really sore for a week or two. Particularly my heels, which suddenly became painful to walk on, especially first thing in the morning.

I put the pain down to my new trainers and decided it was a chance to rest up, and arranged my Fashion Week wardrobe around flats which are thankfully fashionable right now.

At Fashion Week I felt fabulous being 5 kilograms lighter than I was last year thanks to the exercise and eating programme Gaz Brown of GetRunning has had me on, and no one asked me if I was pregnant.

Yes, last year I was asked that question and it was mortifying! I pretended that I hadn’t heard correctly and gave the person an out. ‘Sorry, what was that?’ But they didn’t take the hint. ‘Are you pregnant?’ they repeated. ‘No, I’ve just got fat,” I replied. This was greeted by a pregnant pause of 40-week proportions.

Moving on and jumping a year ahead, it was exciting to be back running after Fashion Week so I was gutted when the heel pain returned.

I immediately booked myself into SportsLab for an appointment with physiotherapist Vaughan Craddock.

Turns out the culprit is inflammation of plantar fascia. Left untreated it can turn into plantar fasciitis (also known as jogger’s heel) which is a common painful disorder affecting the heel and underside of the foot. Bugger.

It’s good that I’ve got onto it early, says Craddock. Some people wait six to 10 weeks before seeking treatment and the longer you leave it, the harder it becomes to treat.

And, I’m not allowed to run. Double bugger.

“The reason I’ve got to take you off running is if you run when the tissue is inflamed it’s only going to get more inflamed. And every day that we keep adding trauma exponentially adds rehab time. For every day it goes on it probably adds a week,” Craddock says.

Nooooooooo! The Queenstown Marathon is less than 12 weeks away!

My new shoes may be the culprit. “If you are in a shoe that is a bit unstable or a bit softer than you are used to or a bit narrower, it’s going to change the way your foot activates to try and create stability,” he says. “It’s not that the soft shoe is bad, it’s just a big change and your body has to adapt. The quicker you force something to adapt the more likely it is to get inflamed.”

The reason the heels become tender to walk on in the morning is because the inflammatory chemicals “settle in”.

“They are proteins suspended in fluid,” explains Craddock. “Those proteins, if they sit somewhere long enough, start to bind like glue and when you get up in the morning and stand on the ground you have to break all those adhesions that have formed and it’s created receptor pain because those proteins, as they are binding, release little chemicals that irritate all the receptor endings and so you are super sensitive. But then you get moving and the blood flow starts to get going and you flush those irritants out but then the process starts again.”

So how do you fix it?

“We’ve got to break the cycle. We’ve got to stop you adding trauma each day. If we don’t deal with this really well now we are going to be dealing with this months down the track. The fastest way to treat this is to get blood flow to the origin and the best way to do that is with acupuncture.”

Blood drains from my face and I break out in a sweat.

“I hate acupuncture”, I wail. “What are the alternatives?”

Strapping the feet, icing them, taking an anti-inflammatory and getting into supportive shoes but it’s a minimum of 10 days off running if I choose acupuncture (fastest recovery option), so despite my aversion to needles I realise with a sinking feeling that if I have a chance of keeping on track I’m going to have face my fear at the pointy end of six microscopically polished needles.

Craddock is straight up about it. It will hurt. He’s right, it’s not pleasant. The needles hurt going in, followed a deep ache though that eases off relatively quickly.

The upside is the needles don’t cause any inflammation so there’s no “trauma”, it’s simply mechanical pain. The reason it hurts is because the tissue is inflamed and the receptors pick up the stimulation.

“If your plantar fascia was healthy and I put the needles in you wouldn’t even know they were there,” Craddock says. “Because the needles are so thin they actually slide between the fibres they don’t rupture anything. They are so thin and flexible that they move through the path of least resistance which is between the fibres so as they do that they stimulate the mechanoreceptors.”

Now that we’ve stimulated the heels I need to rest them. The safest way to do this is to strap them. The strapping helps rest the foot so it’s not aggravated with every step.

“Next we need to release the deep tightness in the flexors here,” says Craddock pointing to the muscles that run down the shin.

He sends me off to see Warren McGregor, SportsLab’s senior massage therapist.

How does massaging the lower leg help heal plantar fascia?

“Fascia is a connective tissue,” explains McGregor. “You generally get tightness of the muscles first and because of where those are and where they connect onto the heel from the Achilles everything has a connection. So if you are tight up the top and tight in the bottom you are going to be tight in the foot. It’s just a logical progression.

“By releasing all of the other structures surrounding and connecting onto plantar fascia we’re hopefully just going to offload plantar fascia even more.”

When will I be back running?

They don’t know but hopefully between three to 10 days.

Zero to three days is the acute inflammatory phase. From three to 10 days you start to remove the swelling and resolve it.

“If this gets inflamed in the heel chronically we are dealing with a three to six month injury. But if we can mop it up we are probably dealing with a 10 to 20 day injury,” says Craddock.

Bugger, bugger, bugger.

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