Treatments for plantar fasciitis: ASTYM, Foot Log, and Birkenstocks

I previously blogged about how I had tried both acupuncture and dry needling for my plantar fasciitis (which you can read about here ). Following the dry needling, my PT Terri Cassel (and her co-worker, John Tunnel, who’s certified and taught Terri) decided to see how my PF responded to ASTYM treatments. ASTYM is like the astymfootPT version of Graston– rather than using stainless steel tools like Graston, they use hard plastic tools. They basically scrape the area that has scar tissue (which is hard/bound up/tight, like a spider web), and this re-stimulates the healing process so the tissue can heal “aligned”. They only do a few strokes (calf, heel, foot, Achilles), as the treatment takes less than 15 min..

What I found is the large, hard, scar tissue knot on my heel, which felt like it was bruising the calcaneus bone with every step, became soft and crunchy with the ASTYM treatments… no longer bruising my heel with every step! You have to stretch after the treatments, and they recommend remaining active through the treatments. As the scar tissue becomes soft and more pliable, you’re trying to stretch the soft tissue back to it’s normal length. Over time, the knot on my heel has shrunk. They said it would take 6-8 treatments to feel a difference, getting the recommended twice a week treatments. I went up to Tulsa twice a week for 4 weeks, and then we did 2 more once-a-week treatments (so 10 treatments total).

Furthermore, I took 2 weeks completely off after the Lincoln Marathon, to see if complete rest would help my foot heal. I think the rest helped it heal just enough and get strong again, so I could return to running successfully.

Last week I finally “graduated” from PT! I’m back on my second week of running and mechanically feeling the best I’v felt since last summer! I would say of all the treatment methods I’ve tried since last August, ASTYM is the one thing that my foot responded to the best. I definitely needed a direct and more aggressive treatment to help break-up the hard knot on my heel. Additionally, they did some ASTYM on my bum hamstring I hurt last summer at Grandma’s, and that helped as well (along with dry needling). I learned through this that I was being too aggressive at home (and inflaming it!), when I tried to scrape my heel with the ~handle of my butter knife, spatula, and other self-massage and stretching techniques. LEAVE THIS TECHNIQUE TO THE PROFESSIONALS!

Otherwise, I’ve chronicled the things my foot has responded to the best since I tore my plantar fascia last August:

  • Minimalist shoes- firm and flexible being the key shoe components
  • Barefoot running 0n undulating grass
  • Rest
  • ASTYM
  • ART and acupuncture (initially); Dry needling later on for more focal treatment
  • FootLogThe Foot Log, which I got 2 weeks ago and is quite amazing, like running barefoot on undulating grass! This guy details how to use it: Foot Log
  • Birkenstock sandals- which I also just got 2 weeks ago. I seriously feel like I bought the Mercedes of sandals! While these seem contrary to barefoot running/minimalist shoes, they actually do feel good. Because your toes kinda have to grip the footbed/toe bar to keep them on your feet… I think that somehow helps the plantar fascia. I tried these on in the store to make sure I got the right size, so I recommend doing this.


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Comments

  1. Clive quinn says:

    Good to hear Camille. Have the foot log myself
    and use it for the foot AND the glute area. Find it great for
    A deep massage. Good luck with your running.
    Any tips on how to run a faster half marathon ? Currently
    at 1:25 and would like to go sub 1:20
    Thanks again
    Clive

    • runcamille says:

      Wow, that’s a great idea Clive on using it on the butt (and maybe even the hamstring attachment). I’ll try it!

      I recommend doing a lot of mile repeats (5-7 at 10K pace, half recovery), and 2 mile repeats at 12K-15K pace (half recovery). Even 3 x 3 mile repeats at HM pace is good, but I wouldn’t do this unless you’re in really good shape and at least 2 weeks out from the goal race.

  2. I have had a similar positive experience with ASTYM and PF. And likewise I wear my Birkenstcoks daily.

  3. Have you ever looked into an osteopathic doctor? I know they have techniques for injuries like PF

    • runcamille says:

      Hi Hannah, that’s a good idea. No, I haven’t been to an osteopathic doctor, but I do have a few friends who are osteopaths. I know osteopaths have manual techniques. The problem is I have very severe PF/scar tissue, not cured by simple massage. I could inquire with my osteopath friends.

  4. Hi Camille! Thank you so much for all your wonderful posts about PF. I was a marathon runner until injuries post pregnancy halted that and I can barely walk a few blocks, and now I have PF in both feet after babying tendinitis. I was wearing sneakers pretty much all the time, and then I just tried out my birkenstocks, and wow what a difference! Also I have been getting ART and Graston for about 5 sessions and doing PT, so I think the combo has been helpful. My question is, what sneakers do you recommend if the birks feel good? My sneakers really aggravate it now and I am looking for other options. Also, I see that you are running on your PT tear and I was wondering if your practitioners recommended to keep moving. I’m sort of scared to walk and am wondering if it might help. Also, when you did acupuncture, was it right at the sight of the pain, in the bottom of the foot? Thanks for everything!

    Adrienne

    • runcamille says:

      Hi Adrienne! Great, glad you like my PF series posts. I’ve done several on the different treatments I’ve tried, and I need to put all of them together on my Health/Injuries page.

      Great, glad to hear you’re loving the Birkenstocks! They’re ‘awesome’! As far as shoes, there seems to be a lot of personal preference on this– I blogged back in January how going back to more “minimalist” shoes has helped me– specifically, firm and flexible.
      http://camilleherron.com/2013/01/21/treating-plantar-fasciitis-with-minimalist-shoes/

      My foot had gotten so stiff/non-functional, from all the built up scar tissue, that I needed to wear less shoe rather than more (as I’d been doing), to get me to “engage” and stretch-strengthen my foot. Mind you, I’d torn my plantar fascia… most people who have “plantar fasciitis” do not have it as severely, and simply need to be in shoes that allow their inflammation to calm down. So I can’t tell you what’s right for you, but be willing to have an open mind and try both extreme– more shoe, less shoe, or something in the middle. The commonalities I found, though, was that the shoes absolutely needed to be firm AND flexible– my foot feels WORSE in overly soft, stiff shoes. Right now I’m rotating a BUNCH of different flexible racing flats, that stress my foot differently.

      I should also add that I eventually had to take “complete rest” in May to allow my foot to fully heal– took 2 weeks completely off, no cross training either. I was still getting ASTYM treatments during this time, which yes, they normally advocate you to continue moving. However, my body needed a break– I think I had run on it in an inflammed state for too long, and it needed rest to fully heal.

      I think there’s different stages of healing– first, you need to rest it to allow it to heal/form scar tissue. Then, you need PT-type treatment, to help resolve the scar tissue/make sure the fibers heal properly aligned. Then, you need to work on functionality– strengthening and stretching. I even blogged about the HUGE difference it

      So you need to think about where you are in the healing stages and have the courage to keep moving forward! Realize though that if you’re ready for the strengthening-stretching stage… it might cause a pro-inflammatory response and feel inflammed. This is Ok! It’s gotta stretch back out to normal. Give it time!

      Also, with the acupuncture– it seemed like the needles were placed more “peripherally”, around the sore area. With dry needling, the needles were placed directly into the area where I had scar tissue– it was quite painful, but I felt like it helped more than the acupuncture.

      • Thanks Camille! I did rest it for about 6 weeks, and I hope that was enough! Now the ART and Graston are making it sore as is the PT, but hopefully I’m on the right path! This is such a painful frustrating condition! It’s only been about 8 weeks since it happened, and I am hoping that it will resolve soon. Am thinking about trying PRP or dry needling if the other techniques don’t work, but my chiro is convinced I just need to break up the scar tissue and stretch it out to accomodate my current walking gait, but he’s able to do PRP too if necessary! Thanks again for your help!

        • runcamille says:

          Ahhh Ok, you’re really early in the healing process. Not to scare you, but it’s been a year since I tore mine, and it’s not 100%… but it’s much much improved! Some days are better than others, but I’ve got it under control and can do speedwork and not hobble afterwards. If I took a day off every time I’m in pain, I wouldn’t have run a step the past 15 years! Feet are tricky– my right foot hurt for almost 3 years, and suddenly felt better one day.

          At some point you’ve got to dive in and keep moving forward/be pro-active– doing the PT-rehab, self rehab, and running-specific strength-flexibility (like hills, barefoot running/walking, etc.). It’s a progression– little bit at a time, as it gets straightened out. I think the more direct/aggressive the treatment, the better… which is why ~ASTYM/dry needling worked better for me than ART/acupuncture (which are less aggressive).

          • Yes I am totally early :)…my mom’s took 18 months to heal! Just trying to avoid having it last THAT long. It’s hard to know what helps and what hurts sometimes! Will try dry needling/ASTYM if all else fails. Thanks!

  5. Hi Camille, how does pf come on? I am noticing the bottom of my foot is really sore around the arch. it came on yesterday. I am not running but my gait is off due to a hammy injury. what are the things to watch for with this injury?

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