Hi Tussockface
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First, it came on after I'd resumed running too quickly after an ankle sprain. Tight calves/ankles are always an issue for me and my whole lower leg had even less flexibility after the injury. This put more strain on the foot structure. When I upped the pace on tarmac (a road 10k) it gave up.
A classic example of returning too soon, because PF is a non-contractile tissue, it is greatly influenced by the contractile tissues which attach to it, therefore if these tissues become tight such as gastroc (calf) or soleus, it can have a knock-on effect and irritate the PF
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Over the last few days I've found that I can run OK off-road, but tarmac triggers recurrence. I have a new theory that the cushioning in my road shoes isn't good enough, and am off to buy a new pair tomorrow
Sounds a good idea, if you have a particularly high or flat arch, then having the right pair of road shoes is paramount, far more so than fell running. Lets say you're high, but your shoes support are 'flat', then with repetition on tarmac, your PF will be subjected to a greater degree of 'bowstringing', which if this is coupled with tight calfs will almost certainly lead to problems for the PF.
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I don't think orthotics are always necessary
I agree. I use 'off the shelf' as well as custom made orthotics, but they are never my first port of call. Muscles in the foot can become 'lazy' just like muscles in the lower back, but I wouldn't put someone with low-back pain into a back brace or corset unless muscle strengthening exercises had failed and it was the last resort.
Good luck with it, it sounds promising, just make sure you get a good assessment before purchasing your road shoes.
Hi lilactime
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physio ian . what are your thoughts on surgery for pf ? my doc says its a curative , apparently they now do it endascopic ? ( sorry for spelling ) , and it is very succesful . in and out of surgery same day.
Of all the surgical options for the feet, this is one I'd be in agreement with, obviously when indicated. As previously mentioned, PF is non-contractile, and therefore if it is a chronic problem that has been developing for sometime, possibly undetected for many years until one day pain comes on for no obvious reason, it will have become exceptionally tight and 'shortened', and a release of the tension within the affected area should work well, as is the case for the ITB.
However, it would be a last resort, therapy consisting of rather unpleasant manual, direct pressure to the affected area should always be attempted to its optimum, as although it hurts lots, it can work amazingly well.
As you mentioned, you'd probably have a maximum of 3 injections, which will hopefully help to settle the pain, but it won't be a cure. I've only just picked up this thread so I don't know what has happened previously, but if your pain has calmed down, i'd take advantage of the 'window of opportunity' to get thoroughly assessed to try and identify the underlying cause.
Good luck!