Heel Still Hurts

The St Croix Valley Runners meet in Stillwater at the Northland tennis courts every Saturday morning at 7:00 am. The standard run is five miles, but of course a person can carve out whatever they need. This morning I walked fast with my two sweeties for two miles, then ran ahead to meet the group, intending to run one more mile. Shuffle shuffle, trying not to lift my feet, so the left one wouldn’t have to come down on the plantar fasciitis. It doesn't work, but maybe the pounding is a little less.

Fine for at least a half mile, but then the heel started to ache and I had to walk the rest or risk undoing any hard-earned progress. Later it was a bit sore. Back to ice and all of the other treatments; I hope I didn’t set it back much.

The latest Runner’s World (August 2007, p. 46) about low-level laser therapy for plantar fasciitis. I’m interested. Also our friend Mary gave me an interesting-looking device today, and I will try it and report back.


Hormone & pesticide-free pork, asparagus, organic sweet potato, organic salsa. Weight Watcher estimate: 3 points.

Great Bike Ride

Friend Jim inflated his bike tires and joined me on a nice 50-minute ride this morning. Cool, low humidity, what a great training ride. Only running would be better.

Slight pain in the right knee, not as bad as Tuesday. Icing the plantar-fasciitis heel now, stretching frequently, wearing cushioned shoes at all times except in bed, when I wear the Strassburg sock instead. Heel is pain-free, but still not running.


One of the happiest joys of summer is the fresh fruit and berries.

Organic oatmeal, organic fat-free milk, blueberries, blackberries, organic strawberries, organic nectarine, pecans, organic pomegranite juice. Estimated Weight Watcher points = 5.

I ran!

Slowly, for about 2/3 mile, using very short steps. After that distance the plantar-fasciitis left heel ached just a little, so I switched from the overhead track to the elliptical machine to burn another 420 calories.

The run was not timed. The elliptical “running” took 31 minutes, 13+ calories/minute, 170 strides per minute, “ramp” set to lowest position to most-nearly simulate running. Like all such machine exercises I dreaded doing it, snored all the way through it, but in the end was very glad I had done it. But I’d rather be running!

I’m icing the heel now, and I’m pretty sure that I didn’t re-injure it today. Perhaps I will do more short runs like this, gradually increasing the distance but stopping at the first little sign of pain, cross-training to fill the rest of the time.



Grilled free-range chicken marinated in key lime and organic lemon, organic nectarine, organic swiss chard, sweetened cranberries, pistachios, steamed with a little organic butter. Estimated Weight Watcher points = 5.

Biking Is Supposed to be Easy on the Knees

Sunday and today I treated my sore foot to a one-hour bicycle ride each day. Sunday morning early, I rode into a high-end housing development and tore up the hike/bike trails there, but never saw a soul. Today I rode into the county park, by way of my favorite dirt road along the RR tracks, then onto the park’s grass hike/horse trails. Again, never saw another person on those trails. A real shame. Plenty of people in the camping areas of the park though, that’s a good thing.

One problem: Both days my right knee hurt, directly under the kneecap, after about 45 minutes of hard biking. I hope that goes away. Can’t run, can’t bike? Tell me it’s not so! Tomorrow the (ugh) elliptical machine at the club. Barf.

But I’m going to get that plantar fasciitis fixed one way or another! No running.


Grilled free-range chicken marinated in lime, pickled beets, sugared ginger. Weight Watcher estimated points = 5.

Plantar Fasciitis 101

I may be a doctor in the legal sense, but definitely not in the medical sense. Just a runner with plantar fasciitis, not yet cured. Nevetheless, I've done some research and talked to some smart doctors and here are my current thoughts.

Cause:

There are two things going on: (1) an underlying tightness of the plantar fascia, which is a wide ribbon of ligament under the foot, connecting the toes to the heel and thus supporting the arch, and (2) an injury at the point where this ligament attaches to the heel, resulting in inflammation and pain. It may also cause a heel spur, a growth of extra bone at the point of injury. In my case, as a runner, the injury probably came from overuse of the over-tight ligament. It could also come from some sort of blow to the heel or arch of the foot.

I ran the Avenue of the Giants marathon seven weeks ago and felt a little pain, but not much. A week later I ran a 5k at nearly top speed, which hurt a lot toward the end. That was the time of the primary injury, though the foot was already heading in that direction.

Since then the pain has resoved several times, but reappears if I run a mile or two. I believe that this happens because the plantar fascia is stretched at every toe-off, and eventually the partially-healed connection gives way again. In Grandma's Marathon last Saturday, it gave way after a mile and a half, though I had not run at all in the previous 18 days. I finished the marathon anyway, beating up on the injury, limping in quite late, and restarting the healing clock at zero.

Cure:

Both issues must be addressed, the underlying tightness and the actual injury.

Healing the Injury:

• Stop Running: Because it seems to pop loose every time I do. Doctor BB (a very smart and experienced internist) says it will take three weeks, probably more because I'm old and because feet don't heal as quickly as other parts of the body. This is the part of the treatment that I like the least, even though I do some cross-training instead.
• Wear Orthotics: Dr BB actually "prescribed" Dr Scholls Heel Cushions. These cost only $7 per pair at Walgreens, and I have them in four pairs of shoes now. In my running shoes they are UNDER the insoles so that they provide cushioning without adding much instability. Other doctors prefer more arch support and less padding in the heel (thanks Luke). But for now I'm going with Dr BB.
• No Bare Feet: Not even in the house. I have the orthotics in my slippers and wear them always. Stop beating up on the injury.
• Cold Packs: Several times per day, and especially after any exercise that could cause more inflammation.

Stretching the Fascia (taking care not to re-injure the fascia-heel connection):

• Calf Stretch: This one, with and without knees bent, gently and frequently, especially first thing in the morning. An experienced runner recently told me I should do this up to 30 times per day. Notice that this stretches the foot as well as the calf. If it hurts the heel, the pressure is too much.
• Towel Stretch: While sitting, use a towel to pull back on the ball of the foot, making the toes point up. Several times per day, always gently. I have not been doing this, but will start.
• Night Splint: I use The Strassburg Sock every night. I have a splint too, but find the sock MUCH more convenient, and I think more effective. It holds the foot and toe up, gently stretching the fascia all night every night, also avoiding the pain and re-injury that otherwise occur in the morning after the fascia has tightened up overnight.
• Tennis Ball: Roll a tennis ball or other round object under the foot several times per day, to further stretch the fascia. Some people suggest rolling a frozen bottle of water instead, but I think that's applying the cold in the wrong place and at the wrong time. Cold should be applied at the heel, the site of the injury, and not in the arch of the foot. Further, the fascia should be stretched while warm, not while cold.

This morning I mostly walked three miles with Sunshine and Sweet Pea while the other St Croix Valley runners did their weekly five miles. The heel is virtually free of pain. We'll see whether I can stick it out for three weeks without running, and whether that resolves the problem.

PB and pickle sandwich "recovery" meal:

"Oregon Herb" whole wheat bread with onion & dill, organic peanut butter, dill pickle slices, organic plum. Weight Watcher estimated points = 8.

Grandma's Marathon 2007

Sunshine, Sweet Pea, and I took the train to the start of Grandma’s Marathon, enjoying the ride, the coffee, and the bathroom. The race began under full sun and a temperature of 71 degrees, to the music of Chariots of Fire. A gloriously beautiful morning, unless you wanted to run 26.2 miles as fast as you could.

I started quite conservatively, following the 4:00-hour pace team, hoping to speed up after a few miles if everything was working. I felt wonderful, running for the first time in 18 days. Not a hint of pain. We made the first mile in about 8:30, slightly faster than the target pace. It felt easy, as it should at the beginning of a marathon.

Then, at about a mile and a half, going up a slight grade, something popped in the left foot. Plantar fasciitis was back. Soon I was walking along the side of the road, being consoled by friends as they ran by. It turned out that I could run for a while until it hurt too much, then walk until it hurt less, then repeat. I stuck to the gravel shoulder on the side of the road as much as possible, and later on the grass boulevard along London Road, doing the best I could.

The other problem: Running with a limp, trying not to step hard on one foot, puts extra pressure on the other leg. Around mile eight, I started to feel a little stress in the right-leg quads, and that got worse little by little for the rest of the race. Left heel hurts, right thigh hurts. Originally hoping for 4:00, and imagining a little better, I finally finished in 5:05, 14th of 32 in my 65-69 age group. But that’s the end of whining.

I had fun, too. When you’re hobbling along the shoulder of the road, you can joke with the spectators, high-five the little kids (even some big ones), and taste a sample of beer or a piece of candy if you like. And I chatted with other runners, eventually even re-passing one or two friends who had passed me earlier. For several miles I ran with the 5-hour pace team, sometimes ahead and sometimes behind. At Mile 7, I was able greet my mom and dad again, Grandma’s volunteers since the beginning. The 5-hour pace team gave them a cheer. A little further along I was greeted by my son, who lives right along the race course. At Mile 20 I shook Al Franken's hand and wished him well. At Mile 23, high-school friends and classmates John and Cathy were still waiting to greet me, though I showed up more than an hour late.

The temperature rose to 81 at the finish. Ambulances went past me several times, as the heat and unrelenting sun got to everyone. It affected me less, however, because I was going slower than my normal pace. Toward the end, most of the runners near me were so affected by the heat that they were done running. They were walking, and I was still able to run some of the time. I passed a lot of people, and that’s fun.

Today, the day after the marathon, the right thigh hurts more than the left heel. Stairs, especially, are not my friends. But that will pass in another day or two, and now it’s time to get serious about curing the plantar fasciitis. I’ve been icing it, and will continue using the Strassburg sock at night. Beyond that I need to put together a better plan. NOT running is not an option.

Glycogen Stores

Wouldn’t that be a great name for a sports-nutrition store? “Glycogen Store!” Anyway I used the elliptical machine again. In my modest understanding of running, this last “run” two days before the marathon (one day for some people) is largely to deplete glycogen stores, so that muscles and liver and other body parts will be hungry for carbohydrates tonight and tomorrow. Then the pasta dinner tomorrow night will top those off some more, and also leave carbs in the colon for possible use during the race.

400 calories burned today, roughly approximating a 3.4-mile run, in about 30 minutes.

I’m on pins and needles wondering if my plantar-fasciitis heel, untested in 18 days, will go the distance Saturday. Muscles are a second question. But today Bonnie at the club said “Enjoy the race!” Bonnie is always cheerful and supportive, but she is SO RIGHT! That’s exactly the best attitude going into a race as iffy as this one is for me. I’ll try to run with the 4:00 pace team, and I’ll have fun as long as I can. Thanks to Jim and my sweeties, so supportive, and to everyone else who has given encouragement.

Did you know that you can take the train to the Grandma’s Marathon start line? I’ve done it more than once, and it’s very nice, especially because there is a bathroom right on the train so there is no need to stand in line for the scarce porta-potties. Coffee too. Give ‘em a call at 1-800- 423-1273; they'll save a seat for you.


Wild-caught Canadian walleye, organic lemon, rice (mix of black, brown, and wild), watermelon. Estimated Weight Watchers points = 6.

Rude Jazzercisers

Jazzercise classes are held at the North St Paul Community Center almost every morning. We usually manage to arrange our schedule to avoid those, because of the noise. The entire facility is really just one huge room and the Jazzerciser leaders seem to love loud music and, even more, love to hear their own voices shouting above that music. Today we had to be there during the din, or not go at all.

Normal conversation was almost impossible, even in the other end of the facility. It’s as if Jazzercise leaders are a slightly different breed of human, born or raised to have no consideration for others. Perhaps they are trained that way. I’ve watched them turn up the sound when the facility managers asked them to turn it down, and I’ve seen them mock people who were protecting their ears as they ran by on the overhead track.

Most of the people in the Jazzercise class are women. I’m the first to admit that women are as intelligent as men, or more so, and usually wiser than men. But if that’s true, then who are these women who pay money to stand directly in front of those high-decibel loudspeakers without ear protection? I hope they make better decisions in other areas of their lives.

Anyway I “ran” another 34 minutes on the elliptical machine, about the same amount of time as I would actually run at this point in the marathon taper if I were running. 450 calories expended, about 175 strides/minute, level 8. The good news is that I felt a little discomfort in the lisfranc ligament of the left foot, a chronic and ignorable problem, but nothing from the plantar fasciitis. Here’s hoping that I can finish Grandma’s on Saturday.

More Elliptical

Monday another 30 minutes on the elliptical machine. I can’t run because of the left-foot plantar fasciitis, and can’t ride my bike because of a little problem in the right knee, so the elliptical is what’s left. 450 calories in about 33 minutes, a level of effort similar to the effort of running about 9-minute miles.

Dessert a few days ago:

Blueberries, organic yogurt, organic dates. Estimate: Two Weight Watchers points.

Breakfast Berries

Yesterday, at the suggestion of runner/biker and brother-in-law Cal, I fixed my bike so the seat is high enough. New post, seat, and water bottle holder for $80, all on a bike that cost only $150 in the first place, brand new. Today I took it out for a 1-hour spin, pushing pretty hard. It’s a big improvement. I can’t be certain, but I have the impression that I was mostly able to keep the bike in higher gears than I could last Thursday, when I complained about knee problems. The knee still bothered a little today, but not as much.

The plantar-fasciitis foot hurts a bit today though, after some lawn mowing. First I’ve felt it since the cortisone shot last Wednesday. I took more curcumin as an anti-inflammatory, and will continue the cold packs, the Strassburg Sock, stretching, gel heel inserts, tennis ball under the foot, and more.

Breakfast this morning. Oatmeal is such a great excuse to eat berries:

From the bottom: Organic oatmeal, organic milk, blueberries, blackberries, organic strawberries, roasted pistachios. Estimated Weight Watchers points = 3. I like this photo so much that it's my screen saver now.

Part of breakfast every morning. Sunshine fries two eggs in the tiniest amount of butter. I love these eggs with black pepper and a little salt:


Breakfast yesterday:

From the bottom: organic oatmeal, organic skim milk, blueberries, organic strawberries, organic sugared ginger. Estimated Weight Watcher points = 3.

Challenge Cancer 5k

My sweeties and I went to the Challenge Cancer 5k this morning, where Sunshine and Sweet Pea ran the race in a good time, and eight cancer survivors, including myself, were recognized for remaining athletically active while dealing with our cancers. I didn’t run this race, because Grandma’s Marathon is just a week away now and I want to give my plantar fasciitis the best possible chance to heal first. So I rode my bike a little and took pictures; what a beautiful day and a nice time.

Afterward we headed to the club, where I “ran” on the elliptical for 32 minutes at a rather hard pace, which I believe is the right thing to do one week before a marathon. The machine said 3.9 miles, but my heart rate was about 150 most of the time, indicating a faster pace than that.

The doctor actually suggested taking an anti-inflammatory before the marathon. I’m aware that other doctors might disagree, for several reasons, and that excess use of anti-inflammatories can threaten kidneys and liver, already threatened by the myeloma. So yesterday I tried taking one gram of curcumin, a natural anti-inflammatory with no known long-term risks, and today I took two grams, just to make sure that I don’t have any problems with it. So far so good - I think I’ll take two grams before the race next Saturday.


Catfish, pan-fried in 1 tsp organic butter, organic lemon, oven-roasted organic sweet potatoes, organic catsup, almonds, jicama, and Breckenridge Oatmeal Stout (not shown). Estimate: nine Weight Watcher points including three for the stout.

More Biking

Bicycle again today, 1 hour 50 minutes, distance unknown. The wind was an interesting factor, blowing hard from the south as thunderstorms and tornados began to invade Minnesota and western Wisconsin. White caps on Lake Woebegone. I started out south for several miles, lugging hard into that stiff wind, then looped around toward the west on mostly-wooded trails, exploring several new ones, and finally toward home, making good time with the wind at my back. I think the effort was roughly equivalent to running 10 min/mi, so the aerobic energy expenditure was perhaps the same as running 11 miles.

I would have gone farther but had some pain in my right knee, directly under the kneecap. It doesn’t feel like something that will be with me for long; I think it’s because I started out riding 40 miles last Sunday for my first real bike ride of the season. I don’t feel it when I walk, but it may keep me from biking any more before Grandma’s Marathon. Happily, there is still the elliptical machine at the club, in addition to water running in an actual lake.

Meanwhile, the foot feels GREAT, like I could run a marathon! That’s the cortisone talking, of course. I’m trying hard to do all of the things that the doctor recommended including ice, stretches, shoes with gel inserts, Strassburg sock, and walking softly. No running, and no bare feet. Nine days left until we cross the starting line; then all bets are off.


Grilled free-range chicken marinated in lime juice, broccoli with organic lemon zest, organic parmesan cheese, blackberries. Estimate: Four Weight Watchers points.

Cortisone Shot

Gulp. I got the shot. My regular doctor is on vacation this week, but I’ve lost patience with my plantar-fasciitis foot, so I went to see his office mate, another very experienced doctor. He confirmed my diagnosis that the problem really is plantar fasciitis, and offered considerable advice. Here is some of it:

• The inflammation will not heal unless I stop antagonizing it, and even then will not heal quickly. In the best case it might take three weeks, and perhaps longer because feet are slow to heal and even longer because of my age.
• Therefore, I need to figure on taking perhaps a full month off from running, though other cardio exercise such as the bike, elliptical machine, or swimming are fine as long as they don’t annoy the foot. Meantime:
• Ice it for 15 minutes at least three times per day. He is an advocate of ice, rather than heat, although he allowed that various opinions do exist out there. What the heck, I’ll try it.
• Buy Dr. Scholls “Gel Heel Cushions” and use them in all shoes, moving them from one pair of shoes to the next if necessary. I bought a pair of those, and another pair of Dr. Scholls Heel Pain Relief orthotics, which specifically mention plantar fasciitis on the label.
• Don’t walk barefoot in the house or out if it. Always use shoes, with the heel cushions.
• Don’t do any activity that makes the heel hurt. Thus yesterday’s very productive yard work was probably UNproductive for my foot.
• Running on it probably wouldn't do permanent injury, even a marathon, but would set healing way back.
• Runners’ stretches of the calf muscles are good, especially after exercise.
• Use the Strassburg Sock at night. He hadn’t seen it before, but I showed it to him and he thought that it should be as good as the clumsy braces they normally prescribe.
• He showed me another type of stretch used on the edge of a stair. I’ll try it.
• Ibuprofen or naproxen sodium might actually help, by reducing inflammation.
• Surgery is a last resort; there are other things to try first.
• A steroid shot can actually improve the likelihood of healing by reducing inflammation (as does ice), but carries a slight risk of further injury later.
• He mentioned that professional athletes do get these shots, because the current season is so important to them, implying that he wouldn’t be so anxious to give one to an amateur athlete.

I mentioned that I run Grandma’s Marathon quite competitively, and that my mom would be waiting for me at mile seven this year again, probably for the last time, because my folks may not be volunteers there next year. So he administered the shot. It contains both cortisone and novocaine, and it actually numbed the heel at first. Now the novocaine has worn off, and the heel feels about as it did before the shot. Ice treatments to follow.


Big salad: Bed of organic lettuce greens, organic celery, diced jicama. With avocado, blue cheese, artichoke hearts, organic strawberries, brazil nuts, raspberry vinegar. Estimated Weight Watcher points: 4.

Long Run by Chainsaw

Well not really. But it felt like it. The plantar-fasciitis heel still hurts, so I did yard work for five hours, including three hours of mostly clearing downed trees and brush.
Several years ago we had a lovely "nature walk" in our little woods, including white violets, trilium, jack-in-the-pulpit, three varieties of sturdy oaks, ash, elm, two types of linden, birch, spruce, cedar, and more. Trees had fallen across the path, and it had disappeared from disuse. So today, after mowing the lawn, I got out the chain saw and cleared that path again. As part of that work I took down and sawed up four eight-inch diameter spruce trees, killed by the power company which topped them so they wouldn't hit the power lines. A lot of sawing, lifting, and carrying.

Unfortunately, the heel didn't get better today. In fact, it got worse. Tomorrow I will try to get in to see my primary doctor, and probably get a referral to a specialist. I'm a runner who can't run, a fish out of water, and I'm getting upset because I'm doing all of the things that I should do and it isn't getting better.


Salmon bake with wild-caught canned salmon, yogurt, dill, and paprika. Sauteed sweet purple onions, peas. Estimate: five Weight Watcher points.

Reecom Weather Radio Review

Our very old Midland weather radio expired, and we went to Radio Shack for a new one, only to find that they were out of stock. No reasonably-priced weather radios on hand at all. So we turned to the internet, ordering a Reecom R-1630 Alert Radio from Weather Connect.

Bottom line: It works as advertised; I'm quite pleased with it.

• It has S.A.M.E. technology, allowing us to program it to sound off only when our own county is included in an alert, whereas the old radio sounded off for any county within the range of the Twin Cities NOAA radio transmitter, a much larger area which included several large Wisconsin counties.
• I have actually programmed it for our county and several counties to the west, where storms usually come from, and recent alerts have confirmed that it works correctly. In fact, the memory now shows 18 alerts in the three weeks that we have owned the radio.
• The owner's manual is a little clumsy, and the radio would be hard to program without it, but I actually had no trouble with the programming.
• Siren (alarm) volume is separately adjustable from radio volume; that's nice.
• Alert duration (time until the radio goes silent again) is not adjustable but is short; that's even nicer.

I don't own stock in the company, and I can think of improvements that could be made. For example, with batteries in the machine (it works even when power fails), it's hard to tell whether it is plugged into house power or not. It should have an indicator. Further, it's a table model with no holes in the back for hanging it on a wall. Duh. But the bottom line is that it works.

I saw part of an advertisement on TV yesterday that Rainbow stores (or one particular store?) will be selling this radio in the Twin Cities this weekend for $30. If so, that's a much better deal that I got on the internet. This is the time of year to have one; in Minnesota, there are more tornados in June than any other month.

Long Run by Bicycle

A new experience today. I’m a runner, not a biker, so I’ve never deliberately ridden a bike as far as I could in three hours, until now. Forty miles even, in 3:13. Not at all Lance-like, barely over 12 mph, but my hybrid bike is slow and I’m old, so I’m content with this “run.”

The plan was to work very hard for three hours or more, simulating a 20-mile run, in hopes of retaining whatever cardio-pulmonary fitness may be left over from the marathon four weeks ago, and possibly even improving my body’s ability to convert fat to energy. The specific fitness for running may slip during the next two weeks (and the previous three) but that’s the tradeoff.

I’d rather be running than biking, but I’m not going to run at all until Grandma’s Marathon, in hopes that my plantar-fasciitis inflamed foot will heal so that I can finish the marathon. Breathing was fast enough to qualify as a hard workout, three or four half-cranks of the pedals per full breath, and even faster toward the end as I tired out. I took lots of water but no gels.

I did get pretty tired, not being accustomed to long, hard miles on the bike, and I slowed down some during the second 20 miles. Now, afterward, when I go up a flight of stairs it feels like I’m carrying a second person. I suspect I’ll feel this ride in my legs in a day or two. The foot gave me no trouble at all; biking is apparently a non-event for plantar fasciitis.

"Men's Bread" (a sample my sweeties brought from a race), whole-wheat bread, parmesan cheese, cheddar cheese, dill pickles, roquefort mustard, organic cashews, organic strawberries, tortilla chips. Estimate: 11 Weight Watcher points. The cheese alone is 6 points.

It'a a recovery meal because it has (1) Carbs (bread), (2) Protein (nuts & cheese),(3) Salt (chips, pickles, & cheese).