In response to our recent post, with this diagram, Walter Fraser kindly presented his story in light of our proposed progression of this painful disease.
Our research on the human disease, so-called (mistakenly) plantar fasciitis, continues, resulting in data sets that are helping us to make sense of why some treatments work sometimes in some people, and why some people never seem to be able to escape this horrible condition.
Walter Fraser, runner, thinker and great supporter of our efforts.
People’s stories, about the progression of plantar fasciitis, based on personal experience, are a critical part of our research program. Please consider sending your story to our Facebook Page, and sign up for our Plantar Fasciitis Research Newsletter at this link.
Today we present Walter Fraser’s progression story, based on the diagram at the top of this page (in his narrative, below, he numbered the boxes from one to eight, starting at the center of the spiral). Follow the spiral, clockwise, from the center.
Fascinating stuff, Walter – this is how we understand disease, by observing one case at a time, seeking patterns. Now, I think I now know why some treatments work sometimes for some people, and why those treatments have been ‘naturally selected’.
Walter’s Plantar Fasciitis Progression Story, [with comments by FitOldDog in bold and blue].
- Genetic predisposition
High arches – I have the same!
Heel striker – [probably due to a meme, rather then a gene! I used to be, but I fixed it in the sandpit with the help of Danny Dreyer].
Walter in the Great North Run – click image for link to his Page.
Possible poor blood circulation – [maybe a function of aging rather than genetics, but then, genetics is regulated both genetically and environmentally, to make the ‘old fart phenotype].
- Environmental triggers
2004: Travelling/working abroad forcing me to condense training into limited time windows.
2011: Loosely tied shoe laces due to broken right arm – [interesting one, given the role of injuries in guarding, which can modify biomechanics to the undoing of our athletics, Walter (see my knee story)].
2013: Barefoot running shoes; downhill running on hard surface -been there done that, but I loved the book.
- Proprioceptive imbalance
Walter, clearly a man who lives his life to the full.
I wasn’t aware I had this at the time(s) but for several years (maybe not as long ago as 2004) I have had problems running fast down hills, especially from standing starts. The feeling of careering out of control (a bit like vertigo) became increasingly worse after each lay off with various injuries. When I make a comeback, I usually build up mileage on a treadmill before running outside. A treadmill has no downhill option so, downhill mileage declines with each injury and recovery from it.
- Mild pain warning
2004: Yes but I was unaware that it could be PF, which I’d never heard of. – [When it comes to surviving a disease, awareness is key. For instance, people die, not infrequently, of FitOldDog’s aortic condition, an abdominal aortic aneurysm, because first responders confuse it with indigestion or lower back muscle pain. A smart phone App for differential diagnosis would be helpful in many such situations, as it would for foot pain. I don’t think people (I’m not talking about you Walter) can listen to their bodies with headphones blasting music, while they run – bad idea!]
2011: Yes. I stopped running immediately but still progressed quickly to Stage 8. Many people who don’t run get PF so they might follow a similar pathway (but let’s see what you find).
He also gets around.
2013: Yes: I rested for a few days then tried to race cross-country and progressed to Stage 8 in less than 2 miles.
- Guarding Biomechanics – [I solved a guarding problem of 40 years with the aid of The Feldenkrais Method, thank goodness, as described in the story linked above. It can be subtle but malicious].
2004: I’ve not had time to research exactly what this involves, but there would have definitely been compensating action by other parts of my body.
2011: Some compensation when walking and standing.
2013: Some compensation when walking and standing.
- Severe pain warning
2004: Yes. This followed soon after Stage 4.
In this graph lies the clue as to why each one of these approaches works in some people some of the time, but not in all people all of the time. Think about it!
2011: No. I’d stopped running before this stage.
2013: Yes. This followed soon after Stage 4.
- Biomechanical tissue stress
2004: Presumably, this occurred (I couldn’t immediately find the Zheng Lui article in Vol 18 of the publication. Which No. rather than pages?) – [follow this link, Walter].
2011: Ditto (which means this can happen without Stage 6)
2013: Ditto
- Severe tissue damage
The answer to the treatment conundrum will be presented in our next e-book, coming out soon! Watch this space.
2013: Not as severe as previous episodes
I guess the trick is to nip these things in the bud as early as possible.
Walter, your analysis is very helpful, as we work to fix this problem for millions.
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