May Runs

My episode as a 2nd time PF sufferer and headache

I developed another nasty plantar fasciitis on my left heel after my right heel has recovered from it. The pain on the left heel started around June 2019 and I felt extreme pain on my left entire foot during my first 50KM ultra run in July 2019.

I reduced my running mileage and tried minimalist shoes running but the situation got worse and I had to stop wearing minimalist and returned to cushioned shoes with insoles.

Since then, the heel pain did not improve and I decided to see a podiatrist at Tanjung Pagar in January 2020. Things he advised me to do is to stand on a soft wobble board and try balancing on it, stand on a lacrosse ball, do heel raises, taping with rigid tape with a special technique. Also important to do strength exercises to get stronger and work on my lower back more. Exercises such as squats, lunges, glute bridge, and so on. He even wanted to recommend me a personal trainer! He said if my condition doesn’t improve, I could either try customised insoles or shockwave therapy. He advised running only 2 times a week. I saw him twice, did strengthening exercises and my condition did improve a little but not resolved.

I reduced my running mileage from January to May 2020 and focused more on strength workout instead. Of course, running fitness was hugely affected, VO2max reduced. In June, I decided to start running regularly again even my heel pain was still around. I started slow and easy. The pain did not get worse so I carried on my routine of running 2 to 3 times a week and later on increased to about 4 to 5 times a week. By late August, the pain intensified and I had to stop running again.

I tried to see a Podiatrist at polyclinic instead but was very disappointed. She did not perform a thorough check and only asked me to do stretching and recommend insoles. Since I already have a good pair of insoles, she only added a foam wedge at the bottom to enhance it. She said if that doesn’t work, then I could see a doctor again to ask to be referred to an Orthopedic at the hospital. She said they adopt a conservative approach and for anything more, I have to visit the Orthopedic. I feel this Podiatry service at polyclinic is not helpful at all. They only advise on footwear, insoles, and stretching. No other assessment or treatment plan. It was a waste of time.

Around the second week of September, I was feeling terrible with migraine and left neck/shoulder, and arm aches. Headache on only one side of the head and the pain got worse at night when I was sleeping or when lying down to take a nap in the daytime. I went for a health screening blood test (has been delayed for a few years) and told the doctor about the migraine and soreness on the neck, shoulder, and arm. Result of the blood test was okay, with no major concerns and he prescribed muscle relaxer NSAIDs and Vit B12 pills. 2 days later I went to visit a Physiotherapist for the neck and shoulder ache and the heel pain. She taught me some exercises to relieve the pain (not much help) and did a trial shockwave therapy on the heel.

After 2 days, the tenderness and soreness of the neck and headache were still bothering me, it was a dull ache in the daytime and throbbing pain at night, which lasted the whole night. so I went to see a TCM doctor for the headache as I didn’t want to take too many painkillers. I was given some medicines to take for 4 days. The medicine did not really help and I was still having a very severe headache at night. My husband asked me to see a doctor at the polyclinic and maybe do an X-ray. So he accompanied me to the polyclinic the next day. The first thing the doctor asked me after I told her about the persistent headache and aches at the neck/shoulder was whether I did anything new, new exercises, new lifestyle, etc. I said no. Then she asked if I do any weight training including bodyweight exercises or push-up. I said yes, I have been doing bodyweight exercises for a few months. She asked me to stop doing them for one month and prescribed another type of NSAIDs (a stronger anti-inflammatory painkiller). So I learned that my headache was actually caused by my neck muscle strain. She said X-ray won’t show anything. I felt better the first night after taking the painkiller. But I can’t be taking painkillers forever and the neck muscle was still uncomfortable.

A few days later, I visited my trusted Osteopath who used to treat my right shoulder. He checked on my shoulder and said that the muscle strain on my left neck was quite serious. After 20 minutes of treatment, my neck muscle felt more relaxed and better immediately. I am very thankful for that. I have since stopped taking painkillers and my headache got better too. The headache ordeal took 2 weeks to settle.

So for the whole month of September, I have been unwell and visiting so many healthcare professionals. It has been a difficult month but I am glad it’s all over. Now I started to do light exercises focusing on lower body strength instead since my upper body seems to be quite vulnerable.

Yesterday, I went to visit another Podiatrist (different from the first one) at Orchard after some research. He seems to be a better podiatrist and performed a biomechanical assessment. I was asked to walk and run on the treadmill and he filmed it and showed me my running gait. There are some problems with the way I walk and run. He also measured my legs and found a slight leg length discrepancy. He gave me some advice on how to run better and did a shockwave on my left calf and heel. He also performed left ankle mobilisation and applied rocktape on my left foot. Also placed a 4mm heel raise in my left shoe, taught me 2 dynamic stretches to do before running. I find this visit helpful and better than all the previous podiatrist and physio consultations. Sometimes, it takes a few attempts to find the right one. I will go back there for a few more times of shockwave therapy and see if my symptoms will resolve. Finally, I see some lights at the end of the dark tunnel, though it is still too early to tell. I am hopeful.

All these visits to the doctors, physiotherapists, and podiatrists are very costly 😥. Running injuries can be hard to treat and very costly. Running is not a cheap sport. Running shoes nowadays are high-tech and expensive, doctor/physio/podiatrist visits are expensive too. Lesson learned from this is to address and treat any pain early, instead of continuing running, ignoring pain, and only seek treatment when the condition worsens. It will be very tricky later.

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