From: JW

Date: 6-11-2016

Subject: Repetitive stress injuries, advice

[JW responds to a member who asked for advice about a pain in the arch of his foot when he started running.]

With repetitive stress injuries, the key component is to remove or seriously mitigate the source of the stress. It sounds like running is the source but plantar fasciitis is associated with any long term on foot behavior. People who work on their feet on hard surfaces often get it. Take a look at your lifestyle, identify the things that seem to exacerbate the issues, and try to limit or change those things. Overuse injuries tend to be specific to the individuals habits.

That’s why you will find a lot of contradictory remedies when you research them. If you are habitually barefoot that separates you from the overwhelming majority of people who have this injury. Your injury and your path to healing is not the same as the typical shod person who has the same problem. That is very important. When you seek help, you have to make sure the people who treat you understand that.

The other thing about soft tissue injuries is they take time to heal. There is no magic wand and there really isn’t much evidence that taking one measure or another increases the speed of healing. Maybe orthotics help mitigate the pain and keep you from re-aggravating the injury, but it can also be painfully invasive for someone who is habitually barefoot. Too much reliance on such casts can distort the healing and leave you with weaker, shortened tendons. Though continuing to walk barefoot can be painful because of the weight… depending on how much you weigh… you still have to stretch the tendons some.

I have had some issues with repetitive stress. My left arm has had major issues having to do with being a musician. My feet have had issues, too, having to do with running but also working in warehouses with bad shoes. Standing on stage for long periods can be a problem. I generally don’t do that much anymore. It is easier to manage my antique instruments sitting down anyway. I still go barefoot. I still run, though I avoid running on concrete as much as possible.

I think we are trained to think we have professionals who can somehow make injuries go away but that is never the case. We have to do the work. We have to have the patience. The key is make sure you are being treated as an individual and not as just another person with that problem because these problems do not affect people the same way. It takes time. If something doesn’t feel like it’s working, it very likely isn’t. Good luck.

JW