Disclaimer: I'll of course add in the initial caveat that I am not a Dr., but I did want to provide my story as it might spark some ideas, etc. I sought out a CHEK Level-IV practitioner with whom I have worked with in the past for another issue. Though the original topic was posted last year, I figured that I'd share some info from my personal experience with a PF issue and add it to the vaults.
My PF Experience: After having been hit with 2 bouts of PF this year, I have learned a lot regarding some potentially very helpful ways of at least managing the issue. My PF issue I believe was caused by an opposite side hip issue which caused a shift in weight to the unaffected side, which then took up more body weight when running, longer ground contact time, etc., and then the resulting PF from bearing too much impact. As another caveat, the first bout was in doing something training-wise which was just stupid. I deviated from my normal training, tried an approach I'd never taken before and got hit with PF. The issue never was really treated, just stretching, and it came back with a vengeance!
A Few Potential Causes: This actually leads to one way at looking at PF, as many times an imbalance issue, not just an overuse issue; especially if it is occurring only on 1 side.
http://charlieweingroff.com/pdf/TheT...ggerPoints.pdf
In the doc above, I believe that Dr. Nickelston mentions that you could probably bet on opposite side hip issues. (and I also recommend checking out Weingroff's site, he is MARSOC's lead PT....please don't hammer me on the MARSOC reference ;-)
I just pretty much know in hindsight this was my issue.
Whether the issue is due to hip issues is not something anyone on the internet could actually diagnose. I'd recommend someone like a CHEK Level IV practitioner or someone to start looking at any left/right strength/muscle imbalances. That being said, if you want to go back to hips as a potential culprit, many cases of PF have been traced back to overpronation which also can be the result of improper hip rotation in the form of anterior hip rotation. Tight rectus femoris (and other hip flexors TFL, ITB), illiopsoas (also a hip flexor), lumbar erectors,and lats too can all be culprits in the causing this anterior hip rotation which then can translate in lower extremity compensations such as overpronation. However, folks that run a lot, and even those that are just the opposite and sit on their butts all day likely have tight rectus femoris, hip flexors, etc. and would likely benefit from dedicated work on keeping these muscles stretched well as sedentary folks also get hit with these same muscled becoming overly tight and the resulting postural shifts.
What worked for me at least: As far as what helped me from a treatment end....deep soft tissue work. I use the rounded but still somewhat pointed back end of a screwdriver. I simply didn't want to wait for the order of an NMT tool to come in to give this a go; it worked almost immediately and I kept on using it. Basically I did a lot of very deep strokes all along the bottom of my heel, calcaneus, and even along the bottom of my foot. I did this in multiple directions and get in pretty deep and slow into the heel area tissue., but not on the achilles. I'll do this when squatting and shifting my weight to one foot while in a plantar-flexed position, as well as then sitting on my butt and just pulling my feet back into dorsiflexion and doing the same series of massaging. Typically I really hit the sore and tight areas a little extra in the fascia, but because the fascia lines from the bottom of the foot near the toes all up through the achilles and into the gastroc/soleus area I treat that area as well. In the gastroc/soleus and areas above the achilles I use my thumbs to get in and do the massage work. Basically put my two thumbs together like an arrow point, and run multiple slow deep lines down the gastroc/soleus muscles, and all of the way down to the area right to and above the achilles. The work higher up in the leg is good in case the issue lies there in form of a trigger point and also just in case any resulting overcompensation has started causing trauma which might not be manifesting itself yet.
The old rolling on a golf ball did absolutely nothing for me. For me the deep and direct tissue work is what it took.
Finally, I like some very long fascial stretches of the gastroc/soleus area, in the form of both straight leg and bent knee stretches. I use an angled surface to basically wedge my feet upon, you don't want to try these hanging off of the edge of steps, etc. I go for 3 minutes each side, in both of the two positions. If you are trying these for the first time, you might want to do them in 30 and 60 second holds, alternating sides, as a gradual build-up until you are ready for the longer 3 minute holds. You definitely want to be cautious in not overstretching the first time you do this in the form of putting your foot in too extreme of a stretch position. Where you will have to be cautious is if you get hit with pain especially in the form of extreme tension in the PF area. When I was first doing this after the onset of PF, it was paaaaiiinful. It is also why I'd recommend trying to do the soft tissue work before the stretching as it really takes a lot of tension out of the fascia as well as warming it up.
If you do this, I've always been advised to do all of this on the opposite foot, even if it is not affected. You then run the risk of treating one side and getting better and then getting f*ed on on the other side of the body. Part of massage, NMT, etc., is to provide feedback to the body as well as literally causing some tissue and adhesion breakup. You do this to one side only and it has the potential to cause issues if not balanced out.
Also, go back and forth on both feet/calves, etc. You don't want to beet for minutes upon minutes at a time. The body needs some chance to respond to the stimulus of the massage as well as giving the tissue a break. Don't go overboard the first time you try it.
Personal results: I went from being where I couldn't run for a week due to PF setting in so badly that after that week off, I was stopped cold 5 minutes into a run. Two weeks later I was getting back to some "tempo" effort in some of my runs. A month later I was running 5-6 days per week again. 2 months later I am now back running every day, 2 running workouts per week (10 miles w/ w/u & c/d) and a long run of 12 miles.
Some Extras: What I still do as a precautionary measure if my PF feels a little tweaked is to use a 9V or 6V battery and take electrodes attached to each side and apply them above and below any tight areas in the PF area, for 5 minutes before running. This helps calm area before running if I need it.
This has not been an immediate cure-all and it is something that I still tend to daily. But I am running again and running well. Running specifically (and being Capt. Obvious here) can be a hard activity and very few people want to be told that they will have to do the extras such as which I have to do, to keep running. My PF issue gets better and better and my training is ramping up again. It just comes down to what one really loves doing, I love running and so the extra time staying healthy is worth it to me. (Don't tell this to the general public though, who get an injury and then just give it up and chalk it up to age, or some other excuse). I didn't want to go to a regular Dr. and definitely didn't want to get a cortisone shot as I've read of experiences of some sort of compromising of the fascial tissue quality after the shot. I understand that the shot is for healing but also didn't want to be completely numbed from the pain as it is a signal to me whether something is going wrong, or in the absence of pain, likely a sign of getting better.
Even very elite runners have suffered from PF so I don't view it as age-related, etc. I'd rather have not had the PF issue to begin with. But I do like knowing that I have the knowledge to deal with it while allowing me to carry on.
Anyways, just some info of what has helped me.
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