Running into problems...
Plantar Fasciitis and associated foot injuries seem to be alarmingly common in agility. Ask at any show and you will be amazed at how many people admit to having suffered foot pain or foot injury at one time or other. It happened quite suddenly to Soraya Porter who ripped her plantar fascia whilst competing at the Axstane show. She was referred to Jo Coates, a podiatrist in her area, who helped her get back to agility. Together they have written this article.
It was a beautiful sunny Sunday in early 2014. I was on the start line with my extremely vocal Jack Russell girlie. I decided to do a running start, so off we went at a flat out run. As I pushed off, my back foot (left) gave a horrible tearing sensation. It was like the extra strong Velcro you can buy - that feeling when you try to tear it apart.
The pain was excruciating but, lame brain that I was, I thought that we stood a good chance of getting a placing and so a combination of adrenalin and extreme competitiveness somehow got me round the course. My dog kept giving me odd looks all the way round, but for once she decided not to tell me off for not handling her like normal and we somehow went clear.
As I crossed the finish line, the pain came charging back to meet me. After rewarding my dog, who was now looking at me like I'd grown a second head, I hobbled to the car to return her to the crate. I realised something was seriously wrong, and I was very concerned that I might not be able to make the hours drive home. As is usual in these kind of situations, I was on my own and no-one who lived near me was visible.
I reported to the first aiders, who confirmed my worst fears that I had done myself a mischief and it needed looking at by a medical professional. I sat there with the foot iced and elevated and wondered if that was my agility competing over for the season. I didn't realise at the time, but the short answer was yes! I had become a fully paid up member of that elite agility group known as the 'dodgy foot brigade.'
So having reached this diagnosis, based on no professional specialist advice, they either get some exercises off the Internet, or they speak to a friend of a friend of a friend who was given some exercises and they do those same exercises when they had it. Or they go to a running shop and the sales assistant there gives them some generic exercises and recommends some specialist shoes (usually rather expensive ones!). I am not knocking the running shops. They are a mine of useful information and help but, at this stage, it is sort of putting the cart before the horse – i.e. the individual hasn't actually got a specific diagnosis, they just think they know what’s wrong with their foot – based on no medical training whatsoever.
They may also go into a large chemists - or the Internet again - and buy various types of gel inserts for different area's of their foot. Probably all the time this is going on, they are trying to carry on with agility, walking the dogs etc. and only really resting the offending foot when it hurts and throbs soooooo much that they really can't carry on any longer.
This whole cycle may go on and repeat itself for several months.
I am not taking the mickey out of all this – I was 'guilty' of doing several of these things. The problem is made worse by the fact that many doctors do not really recognise plantar fasciitis and associated foot problems. If one does take you seriously, then you are normally referred to a physiotherapist and or recommended to have a steroid injection in your foot which, I am told, is very painful and rarely effective in curing the problem.
Looking for help
So why is it so few of us do what I eventually managed to do – which was to consult a specialist?
I went to see sports podiatrist on the recommendation of a very kind lady on the Agilitynet Facebook page. It was the best thing I could ever have done – but why didn't I - and many others like me - not think to consult a podiatrist sooner?
This is why I decided to approach Agilitynet to write this article. Firstly, I didn't think to consult a podiatrist because I don't think I really knew what one was, let alone knew that there was such a thing as a sports podiatrist. I mean I vaguely knew that podiatrists had something to do with feet, but I think I got them muddled up with chiropodists and I think I also thought they dealt with old peoples feet and general foot deformities. We are all very quick to seek specialist help and advice on every aspect of our dogs wellbeing, behaviour, structure etc. but we don't do the same for ourselves.
I think the other thing that would possibly have put me off, if I'd thought of a podiatrist, is the price. If they are a specialist, its bound to cost loads of money right? Well, no. When you speak to your doctor you can ask to be referred to a podiatrist. There will probably be a long waiting list depending on where you are in the country, but you can be referred. Or you can claim under your health insurance if you have it. Or you can self fund. As a guideline, for the initial hours consultation which included gait analysis etc .,I paid £45. After that, I had a series of regular half hour appointments which cost £30 a time – I didn't need 'shed loads' of appointments. If you think about all the money you have wasted with paying out for inserts, shoes etc. which didn't fix the problem, the cost of an expert is considerably cheaper.
It turned out that I did not have plantar fasciitis, although it displayed many of the common, similar symptoms. I was given a few, very specific to my problem, simple exercises, which I still do in addition to my regular massage treatments of my left calf and foot - not always a pleasant sensation it has to be said. They work because they have been specifically tailored to my specific problem. I have a special polymer insert in both shoes (both different) and, along the way, she corrected the lopsidedness in my hips caused by an old horse riding accident!
I can't sing her praises high enough and I no longer dread that first step out of bed in the morning when you almost go through the ceiling because of the bruised pain in the damaged foot. My foot is a lot better now, but these things take time to heal and if I forget to do my exercises regularly I soon know about it.
I have asked Jo Coates, the podiatrist who treated me, to write an article about the most common foot injury – plantar fasciitis, and it follows this article. However, if you are dealing with long term persistent foot pain, please learn by my mistakes. Please stop and have a think about what you actually know about your foot injury. Have you sought professional advice? Do you definitely know what is wrong with it? If there was something not right with your dog you'd go see a specialist. Do yourself a favour – if things aren't right go see a podiatrist. Ask on Agilitynet for recommendations and stop self diagnosing – it will save you money in the long run!
Plantar Fasciitis - A Podiatrist's View
Foot pain, especially heel pain, is the worst problem for an active person who spends a lot of time on their feet! The most common cause of heel pain in an active healthy person is a condition called plantar fasciitis.
The plantar fascia is a tough and flexible band of tissue that runs under the sole of the foot. It connects the heel bone with the bones of the foot, and acts as a kind of shock absorber to the foot. Sudden damage, or damage that occurs over many months or years, can cause tiny tears (microtears) to develop inside the tissue of the plantar fascia. This can cause the plantar fascia to thicken, resulting in heel pain. Plantar fasciitis is the medical term for the thickening and inflammation of the plantar fascia. Plantar fasciitis is an incredibly painful, activity-limiting and frustrating condition if it is not treated quickly and correctly.
Ice the painful area
Limit activity to non-impact until your symptoms have settled.
If symptoms remain after following the above treatments, the problem may be due to abnormal biomechanics of the foot. To address the issue and resolve the problem it is highly recommended that a podiatrist is consulted. The podiatrist, a specialist in foot problems, will conduct a thorough assessment of your foot and leg and assess whether insoles, also known as orthoses, in your shoes would be beneficial to address any biomechanical issues.
About the author...
Having initially qualified as a gym instructor and personal trainer in 2000, Jo quickly developed an interest in Sports Injury Treatment and was awarded a higher diploma in Sports Therapy in 2001. In 2003 she enrolled at the University of Northampton to study Podiatry and in 2006 was awarded a 2:1 BSc(Hons).
Following extensive research, Jo realised that a high proportion of the injuries that athletes were presenting with were most likely due to gait and biomechanical abnormalities. To treat the cause of these injuries as well as the symptoms, she determined that gait analysis and insole prescription in combination with sports massage and sports injury treatment would be beneficial.
It is the complete assessment and treatment of both the cause and the symptoms of sports injuries that makes the Suffolk Sports Injury Clinic so unique. Jo launched this dual approach in 2006 and has been helping athletes recover from injury and enhance their performance ever since.
Sports Injury Clinic
First published 1 April 20156