Saturday, September 29, 2007

Where Did the Plantar Fasciitis Go?

Five miles with the St Croix Valley runners, my buddies, no plantar-fasciitis pain. Yay again! Since I’m out of shape and running on pavement (contrary to doctor’s orders) I ran slowly and finished last, with about a 9:18 pace. S’ok for now. This was the first run with the SCV runners in about two months; it’s so good to be with them again.

Also, this was the first run in my BRAND NEW custom orthotics. I now have TWO pairs of custom orthotics, because the second podiatrist didn’t like the ones that the first podiatrist made. The new ones are softer in the heel, and lighter, specifically made for running. More about that in the next blog; I am now a fan of the Brace Place at St Croix Orthopaedics in Stillwater, MN. I was a little concerned about the softer heel, because the cushioned-heel orthotics that I have made myself or bought at Walgreens have not helped much. But so far so good; I’ll use these for running from now on unless there is trouble.

Back to the headline: Why IS the plantar fasciitis going away? Here are some possibilities:

  • Two weeks ago, trail running, I felt pain on the side of the plantar-fasciitis heel rather than in the middle where it’s supposed to be. I was obliged to run two miles on that pain, because I had an appointment and time was short. It hurt a lot, but the pain died down in a couple of days and then disappeared. Perhaps I pulled something loose that allowed the foot to begin to heal more completely; or
  • At about the same time, we began to eat mostly-vegetarian. Could that promote healing? Hmmm. Or,
  • At about the same time we got serious about a gluten-free diet, along with the vegetarian diet. I have no knowledge that I am gluten-intolerant, none of the classic symptoms. I have the impression that the standard test would be skewed by the myeloma, but I do have a son who is gluten-intolerant. Can gluten interfere with healing? Or,
  • I’ve made more effort in the past few weeks to keep the heel warm day and night, to promote healing; or,
  • “Everyone” says that PF gets better eventually. It’s been five months, maybe it’s just time.
You be the judge.

Of course I do continue to wear the orthotics all day and the night brace all night, I do my stretches (sometimes), and I am not under the illusion that the PF is gone for good. I’m running a marathon soon, and that will likely bring it back. I hope not, but I'll run it or limp it anyway.

Breakfast: Organic oatmeal, organin nonfat milk, blueberries, banana, organic plum. Estimated Weight Watchers points = 4.

Lunch: Gluten-free raisin bread, kiwi, organic sunflower butter, organic peanut butter, black currant preserves. Estimated Weight Watcher points = 8.

Salad: Organic romaine, organic peach, organic strawberries, organic walnuts, raspberry vinegar. Estimated Weight Watcher Points = 2.

Dinner: Organic rice, organic salad beans, water chestnuts, organic sweet potatoes, local rutabaga, organic catsup.

Thursday, September 27, 2007

Six Pain-Free Miles

No pain in the plantar-fasciitis at least. The right hamstring is complaining a little, but this has been a chronic issue ever since it “popped” in the Twin Cities Marathon a few years ago, forcing me to walk the last 16 miles. I need to note it in the log, do my stretches, and hope it doesn’t become a problem. I had hoped it would go away completely, doing so little running, but perhaps the biking is just as hard on it. Or maybe it will never heal correctly. That’s the bad news, and not very bad.

The good news: this is the longest run in months free of plantar-fasciitis pain. YAY! And a beautiful morning on the Gateway Trail horse paths, too. Damp from last night’s rain, silent running.

It took me just over 54 minutes, for a pace of about 9:05, which is just fine considering the soft trails and my current level of fitness. Breathing was four footfalls per full breath most of the way; that’s a perfect breathing rate for me in longer runs, or races up to a marathon. It changes to three footfalls per full breath going up hills and near the finish. If it gets to two footfalls per breath, I’m either a few hundred yards from the finish or I’m in trouble and must slow down or walk a bit.

This run was long enough to begin to feel it in the leg muscles, especially the left thigh which has been under-used while I’ve been compensating for the PF in the left foot. But that’s a GOOD feeling; progress is being made.

Bottom line: It’s a masterpiece!

Today's breakfast
Today's breakfast: Organic oatmeal, organic nonfat milk, blueberries, organic strawberries, kiwi. Estimated Weight Watcher points = 3.

Today's lunch
Today's lunch: Sunshine's chard with sweetened cranberries and pistachios, organic butternut squash, organic cheddar, organic salsa, Sunshine gluten-free corn bread (with stuff), organic peanut butter. Estimated Weight Watcher points = 6.

Last night's supper
Last night's supper: Organic brown and wild rice, organic squash, organic home-toasted cashews (by Sunshine), watermelon, organic broccoli. Estimated Weight Watcher points = 5.

Tuesday, September 25, 2007

Gateway Trail Four Miles

The Gateway Trail is getting prettier by the minute. Fall color is coming fast; sumac is already red as can be, maples are starting to turn, and oaks are giving hints. The sky cleared as we ran (my sweeties ran too), and the temperature was a perfect 53 degrees. Best of all, I ran four pain-free miles today; not a twinge from the plantar fasciitis. Nada. Zippo. Only a little faster than 9-minute miles, but speed was not the objective today.

What’s going on? Why is it better now than it has been in months, even though I ran a tough marathon three weeks ago and the foot was still painful as recently as one week ago? Dunno, but I’m going to grab it and run. Literally. And cautiously.

One thing I’m doing differently: I keep the foot warmer, all day and all night. I added an extra layer of cotton sock to the Strassburg Sock night splint that covers and warms my foot all night, and I’ve been wearing a warm sock on that foot all day too, even when the other foot is bare. I suspect that healing happens in warm tissue much faster than it does in cold tissue.

Plan: Six miles Thursday, maybe five Saturday (there are scheduling issues), hopefully eight or ten Monday? I see the podiatric surgeon again Monday, so maybe I’ll run first and come in with very current data. But if so I’ll have to get up plenty early; the appointment is for 8:25 am. It’s worth it.

Today's salad
Tonight's salad: Organic romaine, cucumbers, avocado, organic plum, raspberry vinegar. Estimated Weight Watcher points = 2.

Today's dinner
Tonight's dinner: Organic sweet potatoes, organic broccoli, organic beans, organic brown and wild rice, organic catsup, pineapple. Estimated Weight Watcher points = 6.

Monday, September 24, 2007

Racing Butterflies

Fall is SO much my favorite season! Today I took my trail bike on the big loop of the park. What a lovely ride. Woods and open fields, winged creatures abounded. Twice I found myself following a butterfly. Geese honked overhead in their familiar fall V-formation, celebrating their growing strength for the upcoming southbound journey. Wheeling around a corner, I came upon a hen pheasant. She really didn’t want to fly this early in the morning, and ran down the trail ahead of me as fast as she could, but eventually had to fly into the nearest thicket. And throughout the ride were the first splendid hints of fall color.

Temp was 72 degrees with a strong south wind, weather that so often precedes thunderstorms. The park trails were still a bit washed out from the most recent rainstorms. A few days ago we got an inch and a half of rain in about 20 minutes, and nearly three inches total. Apparently the park did as well.

The ride was energetic, lasting about an hour. Distance is irrelevant because the trails are tough; I used every gear on the bike (there are only seven) including and especially the climbing gear. Heart and breathing rates were right up there the whole time. I stopped just once, to admire the view from a high point in the park. What a great, refreshing ride!

Breakfast: Organic oatmeal, organic nonfat milk, organic grapes, kiwi, organic strawberries, banana. Estimated Weight Watcher points = 6. Basswood leaves fall first in autumn, rather unceremoniously compared with maples and other colorful trees. This one landed photogenically on the picnic table where I often photograph my food.

Salad: Organic romaine, avocado, blue cheese, organic nectarine, organic walnuts, Sunshine's homemade corn & amaranth bread, raspberry vinegar. Estimated Weight Watcher points = 5.

Dinner: Organic vegetable dish (sweet potato, beans, onions, squash), sweet potato chips, parsnips, Sunshine's corn & amaranth bread. Estimated Weight Watcher points = 5.

Sunday, September 23, 2007

MMRF Race for Research 5k

This is my race, a fundraiser for myeloma. I help with the course a little, by certifying it and assisting with directional signs and mile markers before the race. How appropriate that this should be the first pain-free race for me in months. I’m a happy runner!

Friend Jim ran very well, close to his best pace, but I was off my pace by more than a minute per mile. I’m out of shape, because the plantar fasciitis has made it so hard to run, and I wasn’t trying to push the pace. In fact when I did lengthen my stride to speed up near the finish, I felt a twinge and quickly returned to pace. But if this freedom from pain is a sign of things to come, I will relish the chance to train back up to racing form. Whoopee! Easy does it, fingers crossed, podiatrist appointment in eight days. Maybe I’ll have good things to tell him.

Carrie Tollefson, world-class middle-distance runner from Minnesota, has lost a grandmother to myeloma and was there supporting this race. She gave me a solid suggestion for the plantar fasciitis: Folske Clinic, a chiropractic clinic in Golden Valley. She asserted that Wade Folske brought an end to her own plantar fasciitis. I may eventually try that.
Carrie Tollefson Tollefson jogged with the regular runners at this race. Gliding past me with a word of encouragement but no apparent effort, she slowed ahead to run with a young boy for a hundred yards or so. Later I saw her stop to tie the shoelaces of an even-younger boy. After the run she signed posters and chatted with runners until well after the awards were finished. She is not only a good runner but a good person, an example to all of us. We're lucky that she represents Minnesota in global competition, and that she is supporting this race.

For more photos and information about the race, visit Sunshine's blog.

Today's breakfast
Organic oatmeal, organic skim milk, seedless grapes, organic nectarine, kiwi, banana, pistachios. Estimated Weight Watcher points = 7.

Typical salad
Organic romaine lettuce, hydroponic seedless cucumbers, organic peas, crushed blue-corn chips (for crunch and salt), raspberry vinegar.

Grass-fed antibiotic-free bison, organic squash, organic sweet potatoes, onions, organic beans. We're eating mostly-vegetarian right now, not much bison; this photo is from a few weeks ago.

Saturday, September 22, 2007

Three Days

Today, Saturday, Sept 22:

OSI Fall Roundup, North St Paul. We three ran this mostly together today. The bad news is that it took me twice as long as if I had run full speed, but the good news is that my plantar-fasciitis foot didn’t hurt at all. Then I put on work boots and did some yard work, and it did start to hurt a little. Shucks. We'll see tomorrow.

Friday, Sept 21:

Lovely bike ride with Jim, partly on my favorite trail along the railroad tracks, partly on grass, partly paved trails, and partly roads. About 21 miles, we didn’t push hard, and I didn’t clock the time. I think that I should do at least one long bike ride each week, although my right hamstring starts to hurt if I ride every day. The foot feels fine, but I don’t imagine that it would if I ran.

Wednesday, Sept 19:

Measured the new Bolder Dash 5k and 10 races around Lake Nokomis, riding the bike about 15 miles. Measurement of road races is done on a bicycle, specially equipped with a counter that precisely reports the distance traveled by the bike's front wheel. The counter is calibrated both before and after the measurements, by riding a special course previously measured with a steel tape.

Recovery treat:
Recovery treat, take your time eathing this.  I did  :-)
Watermelon, kiwi, organic strawberries, blueberries, organic pear, organic fat-free yogurt, one Dove dark chocolate. Estimated Weight Watcher points = 5.

Tuesday, September 18, 2007

Elliptical Miles

One half mile on the treadmill, and the foot began to hurt, so I switched right away to the elliptical machine and burned 450 calories there. The machine said 3.8 miles in 32 minutes. Heart rate got up to 146, which is rather high but: (a) I’m a little out of shape; and (b) I was still digesting breakfast, which does make some difference. Good exercise, but I prefer running.

I had an appointment for my second pair of custom orthotics today. And I got a bill for $405 for the first pair today as well. Medicare covers the doctor visit, but not the orthotics. I suppose the second pair will cost a similar amount, but I hope they are a little more appropriate for running. Anyway OUCH!

Pot roast dinner
No-hormone no-antibiotic beef roast with organic sweet potato, organic carrots, onions.

Estimated Weight Watcher Points = 5.

Friday, September 14, 2007

Four Mile Run

Forty minutes of cool, morning running on grass trails. I meant to go about half that far, but made a wrong turn in the park and then I was committed. Lovely, delightful run, except that the plantar fasciitis foot did hurt some, especially in the last mile or so. In fact it hurt in a new and different way, I think, more on the outside of the heel instead of the bottom. Not sure what’s going on there, but it still hurts as I write this in the evening. Sigh.

But it really was a nice run otherwise. And interesting. As I drove in, there were police cars all over the place, some from Duluth. I parked and took off on a jog anyway, passing an officer in plain clothes. I half expected him to say I shouldn’t go down that trail, but he didn’t, so I asked him if this was just an exercise and he affirmed that they were training. Later I saw canine units, and the police cars seemd to be spread out all over the park.

Salmon dinner
Wild caught Alaskan salmon (canned), organic yogurt, local dill, paprika, organic rice chips, organic peas. Estimated Weight Watcher points = 7.

Wednesday, September 12, 2007

Two-Mile Recovery Run

We three went to the park and ran on grass and dirt trails, just an easy run since we ran a tough 28-mile marathon just last Saturday. No real problems, the muscle soreness in my right thigh (from compensating) was worse than the left plantar-fasciitis heel, and neither was very bad. Very enjoyable little run.

Looking back at our conversations about plantar fasciitis (PF) with the two podiatrists, there are a few things on which they definitely agree:

  • PF goes away without surgery, one way or another, 90 to 95% of the time.
  • Surgery is to be avoided if possible.
  • Stretching several times per day is important to correcting PF.
  • A night splint is important. Both thought that the Strassburg Sock was a good splint.
  • Custom (not drug store) orthotics are important, both for running and while not running, though they did not agree on the nature of the orthotics. One made them with a fairly hard heel, and the other prefers soft.
  • Neither podiatrist cared what shoes I wear for running, as long as they are comfortable and contain the orthotics.
Some opinions by Don, for what little that’s worth:
  • The Strassburg Sock (night splint) is much more comfortable in bed than a hard splint, and may even do a better job. It’s the first thing to try and may resolve a mild PF problem (morning pain) all by itself.
  • Orthotics are a mild inconvenience, but not really that bad. I wish I had more than one pair so I wouldn’t have to keep moving them from one pair of shoes to another. What feels good is an orthotic with some arch support and a very cushioned heel. I don’t know if that is what will cure PF, however.
  • Stretching is the hardest; I just don’t seem to get up and do it often enough. Some days have gone by with no stretching at all.

Today's lunch:
Recovery lunch
Turkey bacon, kiwi, chard dish (organic rainbow chard, organic olive oil, Door County dried cherry/cranberry/blueberry mix, almonds, purple onion), shredded organic raw cheddar cheese. Estimated Weight Watcher points = 7.

Jog in the park

Tuesday, September 11, 2007

The Foot Surgeon Recommended ...

NOT surgery. Not yet. Imagine! He has more things to suggest before we try surgery on the plantar fasciitis. I don’t think he was very impressed with the other podiatrist’s recommendation of two months of "hammock therapy." And neither was I - it didn’t work and it seems I wasted two months. He was also not impressed with the custom orthotics that the podiatrist had made for me, with a rather hard heel plate; he prefers a softer one, so I will be getting ANOTHER pair of custom orthotics. Interesting factoid: I got in to see the orthopedic surgeon in ONE DAY, but the appointment for the orthotics takes at least a week, no exceptions, “Ron” is very busy. Is there a message there?

Whether there is or not, I really like this doctor. He is a board-certified podiatrist and podiatric surgeon. He is young (compared to me) but not TOO young, he didn’t recommend surgery as the first option even with my history, he is a very competitive runner and triathlete, and he was VERY informative. So much information that I wish I’d taped it. Happily, Sunshine went with me, so we can compare notes. I had an appointment with the other podiatrist too, and I just cancelled it.

This guy is my new foot doc. His name is Troy A. Vargas, D.P.M., at St. Croix Orthopaedics, centered in Stillwater, Minnesota. Here are some of the things I heard him say (not to be confused with whatever he ACTUALLY may have said):

  • Plantar fasciitis can be cured without surgery 90% - 95% of the time.
  • It appears more in aging people, so may be somewhat of a degenerative problem.
  • The surgery is simple and quick - just a few minutes to remove the center (usually) of the fascia where it attaches to the bone, and put in a few stitches. The only surgical issue is getting through the layer of fat which forms the heel pad. The body ultimately replaces the removed portion of fascia with scar tissue.
  • There is a potential complication of nerve pain CAUSED by the surgery, which is very hard to treat and is the primary reason why doctors are slow to treat plantar fasciitis with surgery. It can make the pain worse. As far as he knows this complication has never appeared after one of his surgeries.
  • Running on grass trails is much better than running on pavement. Go to the park. I will!
  • A second steroid shot is not out of the question (I’ve had one already).
  • Night splints are good - keep it up.
  • Stretches are very important - several times per day, both the Achilles’ tendon and the hamstrings; that’s all connected.
  • He suggested all sorts of cross-training: Biking, pool running, swimming, elliptical, and more. Of course.
  • I didn’t ask about hot and cold treatments, and he didn’t offer anything.
  • There is another therapy (I missed what it was exactly) that he might want to try before doing surgery.
  • He knows that PF is impacting my lifestyle, and that is an important consideration.
  • There is a theory that some cases of PF may become chronic, without inflammation, and if so the correct medical term would be plantar fasciosis instead of plantar fasciitis.
  • In an aside, not discussing PF in particular, he did mention that sometimes an injury will rupture and then the pain will actually go away. I think he was implying that’s what may happen in some cases with PF.
Specific, immediate instructions for me:
  • OK to run on grass, be guided by the pain. Yay!
  • Avoid hills.
  • Go immediately to the Brace Place (do not pass GO) and get new orthotics by Ron. Wear them all the time, including running.
  • Continue with the Strassburg Sock night splint.
  • Stretch the Achilles, calves, and hamstrings several times per day.
  • Come back in three weeks for a steroid shot (one week before my next marathon).
I’ll keep posting. I really would like to stop writing about plantar fasciitis pretty soon, but today I feel hopeful and cheerful. Despite the pain at the end, the Moose Mountain Marathon was a delight, and now I have a doctor in whom I feel some confidence. This day is a masterpiece!

Monday, September 10, 2007

More Moose Mountain Marathon Pix

Hover over a picture to see remarks about it, click to enlarge it:

The marathon starts at Cramer Road west of Schroeder, and goes northeast toward Lutsen

Fall color wasn't in full swing yet, but there was plenty to enjoy

sweet spot in the trail

Rushing rivers abounded, even in these times of drought

I love these stands of birches

Near the top of one of the mountains

We also enjoyed the trip up and back, along the shore of Lake Superior.  Split Rock Lighthouse

Believe it or not, this steam engine was hurtling down the tracks between Two Harbors and Duluth, pulling a passenger train, on September 9, 2007!  Man could it whistle!  We weren't the only ones stopping to take pictures

Plantar fasciitis still hurts, and I have an appointment with a podiatric surgeon tomorrow morning. Can't wait to see what he says!

Sunday, September 09, 2007

Moose Mountain Marathon

What a marathon! The Moose Mountain Marathon is one of three simultaneous races traversing sections of the Superior National Hiking Trail. Besides the marathon there is a 50-mile and a 100-mile race.

We three “only” ran the marathon, but that is a far tougher course than any other marathon I’ve ever run.

First we spotted ourselves a two-mile handicap by missing a turn at the START. I was just livid when I found that out (but maybe at myself?). However, it’s very hard to stay angry when surrounded by so much natural beauty, and with perfect running conditions, the temperature varying only between 52 and 57 degrees all day.

After the iffy start, we hiked (no running for us) another eight miles to the first of three aid stations, then continued on to the others. The trail is sometimes very nice, soft earth, but more often it is obstructed with roots and rocks. There are lots of long uphill and downhill treks, and those are usually the rockiest parts of the trail. In a few places, it would be very hard to navigate the trail without using hands to steady oneself.
Runners waiting to start
Natural beauty
Beauty every inch of the trail
Fall is on the way

One of several incredible waterfalls.  This is the Temperance River

Sometimes the trail is easy, like this

But often it's rocky and difficult, like this

Or full of roots, which do their best to reach up and grab your foot
The fastest runner this year actually did finish in just under four hours, but people who do that can probably run a paved marathon in 2:30 to 2:40. One friend who can normally run a marathon under 4:30 needed over eight hours last year. It’s a TOUGH, challenging race, not just for people who are competing for a place but for anyone trying to finish it at any speed. The incredible beauty of the Superior Hiking Trail is the compensation.

This race has few rules, but does have cutoff times: You may not leave the last aid station after 5:00 pm unless you have a flashlight or headlight. Further, you may not leave the last aid station after 7:00 pm, period. We arrived there at about 5:50, and my sweeties decided that they wouldn't risk running the last leg on very tired legs in the dark. So I donned a headlamp and took off for the finish, traveling the last seven miles in a little less than two hours, much of that in semi-darkness.

It rained for the last half hour or so, making the trail a little more slippery, but otherwise not causing a problem. In this segment I did run, as fast as I could, walking the steep uphills, the treacherous downhills, and wherever else the trail was too uneven to run safely.
I loved traveling with my sweeties, but I loved this part too, crusing alone, almost silently, through the forest as fast as possible. It’s hard to believe that I averaged only 17 minutes per mile; it sure felt faster. Must be more than seven miles :-)

The casualty, unfortunately was the plantar-fasciitis foot. It hardly hurt at all hiking into the last aid station, then started to hurt a little more as I ran the last seven miles, and finally hurt a lot when I reached the pavement of the last half-mile.

It seems like the podiatrist-recommended two months of “hammock therapy,” with night splint every night and special orthotics, didn’t help at all; the PF came right back. Two wasted months. It still hurts today; we’ll see about tomorrow. Maybe it’s time to see if a surgeon has any advice. The marathon was delightful, but the foot is a big disappointment.

See more Moose Marathon information on Sunshine's blog Best Day of the Year.

Triple threat: Roots, overhead log, narrow boardwalk
Always the beauty
Happy finisher.  Wet shoulders from the light rain

Wednesday, September 05, 2007

Plantar Fasciitis is NOT Gone

Wednesday, Sept 5:

Running is out because of the plantar fasciitis, and biking is out for the moment because of a hamstring problem that seems to be made worse by biking. So today my sweeties and I went to the park reserve for some trail training. I walked fast, and they walked & ran to keep up. We went 3.8 miles in 1:02:00, which is not fast, but fast enough.

We will be running a trail marathon before too long, so this was a dress rehearsal. We all got our feet wet, which will probably also happen in the real race and we’ll have to deal with it. I learned that I should have applied skeeter dope! All around it was a good experience. We may do something like that tomorrow, and adjust our pace more closely to the pace we’re shooting for in the marathon.

Unfortunately, I did feel the PF heel again today, so I wonder whether it will be ready for another race anytime soon. Guess we’ll see.

Monday, Sept 3:

Because of the resurging (lurking) plantar fasciitis, I walked the Victory 5k rather than run it. That’s nice too, because I walked/ran with my sweeties and got some good photos. The PF didn’t seem to get any worse.

I certainly enjoyed seeing some of my good running friends as well. Been too long. If it turns out that I can’t run, maybe I’ll need to volunteer at some races to keep those friendships going.

Saturday, Sept 1:

Buckshot 2 mile race in Eau Claire. I started fairly far back, not knowing how it would feel to race. As it went along I felt fine and passed quite a few people, but took second place in my age group to a good runner. I’m quite happy with the race result.

EXCEPT, the plantar-fasciitis foot hurt a little, just in the last half mile or so. I slowed a little when I felt that, and it didn’t get worse, but it’s really quite discouraging. The doctor said that two months off “almost always” cures PF, but it’s still there, lurking. Drat. I don’t like to cuss in my blog, but if I did this would be a time.