RUNNING WALKING RACING TALKING
Issue 2 April 2018
by Brian Fullem, DPM
Gasparilla Race Weekend Photos 4
Treatment for Plantar Fasciitis 12
Girls on the Run 16
Clearwater Bridge Run 18
Goody Goody Sunday Runs 22
Safety Harbor Run 28
Lake Rogers Park Run 34
Run Tampa Race Calendar 36
Running Podcast Information 40
Group Run Information 41
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There are more than 3 million doctor visits per year by people with heel pain. Most of these cases are plantar fasciitis and the medical literature typically reveals that up to 90% of the time, heel pain resolves with conservative treatment.
- by Brian Fullem, DPM
The Importance of Stretching
The classic symptoms of plantar fasciitis include more pain with first steps in the morning and first steps after sitting. The onset is typically insidious and most of the time, the symptoms will progress unless treatment begins. It is very important to ascertain the nature of the pain and symptoms to make the proper diagnosis. For a runner, if he or she continues to work out in the presence of plantar fasciitis, then compensatory injuries and pain may also occur.
One must be able to distinguish the injuries that compensation causes and decide if the other injured areas will resolve with successful treatment of the plantar fasciitis or if treatment is necessary.
DiGiovanni and colleagues published two studies that propose non-weightbearing stretching of the fascia along with massage of the area as effective parts of the treatment plan. This method is preferable to applying body weight and force on the fascia when one attempts to stretch the fascia by hanging off a step or putting his or her toes up against the wall.
Pull the toes back and massage along the fascia with your thumb. Hold the stretch for 10 seconds and repeat 5 times several times a day.
I will typically advise my patients to perform calf stretching by leaning against the wall and holding the stretch for 30 seconds and have them repeat five times at three different times during the day. If patients have a lot of pain during the first steps, I recommend they do the DiGiovanni type stretch prior to getting out of bed in the morning.
If you are having heel pain then first check the most common shoe gear that you use daily and the your running shoes. It is important to note any changes in activity level and any changes in shoe gear. If you work at a job that requires a lot of standing, this adds another layer of difficulty in resolving the pain. These patients may benefit from an insert in the shoes and a good, supportive work shoe. Runners that have put more than 300 to 400 miles on a pair of running shoes, should consider purchasing new running shoes. If you have switched from a traditional 12 mm ramp angle into a lower or even zero drop or a more minimal shoe; this can trigger calf soreness and tightness, and lead to plantar fasciitis.
I will rarely prescribe non-steroidal anti-inflammatory drugs (NSAIDs) for any problem and NSAIDs are not very effective for plantar fasciitis. Lemont and colleagues have published studies showing there are no inflammatory cells in chronic cases of plantar fasciitis treated surgically. The authors propose that there is more of a degeneration present. The magnetic resonance imaging (MRI) findings of plantar fasciitis are mainly thickening, which is consistent with a fasciosis or a degenerative process as opposed to inflammation. The side effects of NSAIDs far outweigh any benefit that their use might achieve, and it is certainly far from prudent to have someone on these drugs for longer than a few days. Treat the cause of the injury and not just the symptoms.
Many physicians including myself will inject the plantar fascia with corticosteroids. Landorf reviewed the medical literature for plantar fasciitis treatments and only found two articles in the recent medical literature that support the use of corticosteroids as an effective short-term treatment. I will typically only offer an injection if the patient has had symptoms for less than two months or if they have an important race coming up and if one injection does not resolve the symptoms for longer than two to four weeks, then I will typically not offer another injection.
While the foot is symptomatic, I encourage good support and often prescribe an off-the-shelf arch support to wear during any activity. I often have a custom orthotic device as part of the treatment plan, but I have found in many cases that it is worthwhile to try an OTC-type insert initially. I discourage going barefoot or wearing flip flops while the symptoms are present.
Taping can also work very well, I typically use Kinesio Tape with one strip along the bottom of the foot from the toes going around the back of the heel and a second going across the foot in the arch.
By far, the most effective treatment according to the medical evidence and in my practice is extracorporeal shockwave therapy (ESWT). The new radial ESWT units are portable and one can and should initiate treatment on the initial visit in chronic cases of plantar fasciitis. Shockwave works by inhibiting substance P, which governs pain impulses. The main benefit that helps the tissue is neovascularization of the painful area, which theoretically leads to better perfusion of the area. However, one should not wait until the pain becomes chronic. In fact, shockwave may possibly work better the earlier in the treatment plan that ESWT begins. I would never consider surgery for plantar fasciitis unless the patient has had a course of shockwave therapy.
In our office we offer two different types of shockwave, both of which can be effective for heel pain.
It is important to advise patients that the treatment will not reduce the pain as quickly as a corticosteroid injection. I typically advise my patients that they will not feel any improvement until at least six weeks after the treatments are finished. If the patient has improvement during the treatment phase with ESWT, then I anticipate a full resolution of symptoms soon. I recommend that patients continue to stretch, ice, tape and keep the foot supported. If patients are not limping or compensating, then they may continue their workouts.
Once the symptoms begin to resolve, I encourage the patient to work to improve the strength of the intrinsic muscles of the foot and proprioception. I advise my patients to balance on one foot while brushing their teeth twice a day, progressing to balancing with the eyes closed. I also recommend patients pick up a towel with their toes and lay a towel flat with a book at the other end and pull the book toward them with their toes.
In the next installment we will discuss treatment and care of other causes of heel pain.
What About NSAIDs And Corticosteroids
Dr Brian Fullem is a Podiatrist in Clearwater, FL specializing in sports medicine. Dr Fullem is a Fellow of the American Academy of Podiatric Sports Medicine and also coaches the distance runners at Dunedin High School. Dr Fullem ran at Bucknell University and has PR’s of 8:50 for 2 miles and 14:25 for 5K. For more information visit www.EliteSportsPodiatry or follow Dr Fullem on Facebook at Elite Sports Podiatry or Twitter at @Fullem_ESP
What is the best treatment?
Shock-Wave Therapy for Heel Pain
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Apr 14 5K4Q, Gibsonton Register
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Apr 14 Race for Fox in Your Favorite Sox 5k, Tampa Register
Apr 14 Rotary Runs the Beach 5k, Indian Rocks Beach Register
Apr 14 Run With the Flock 5k, St. Petersburg Register
Apr 14 SPC Titan Trot 5k, St. Pete Register
Apr 14 Starkey Ranch Distance Classic 10k/5k, Odessa Register
Apr 14 The Florida Run @ Colt Creek State Park Register
Apr 14 Viking Invasion 5k Run/Walk, Lakeland Register
Apr 15 Hunger Run 5k, Tampa Register
Apr 20 ★Roar Through Ybor Race for Sight 5k| RUN TAMPA GROUP EVENT★ Register
Apr 21 Palm Harbor Spring Fling 5k egister
Apr 21 Robbie’s Run 5k, Hudson Register
Apr 21 Tampa International Airport 5k on the Runway Register
Apr 21 Withlacoochee Moon River Run Half/10k/5k, Brooksville Register
Apr 22 Run for the Arts 5k, Dunedin Register
Apr 28 15th Desoto Grand Parade 5K – Bradenton Register
Apr 28 Let’s Beat Ovarian Cancer 5k, Tampa Register
Apr 28 Ryan’s Run 4mi/2mi/relays, Tampa Register
May 4 Send Me Missions 5k, Wauchula Register
May 5 Bouchard Insurance 5k, Safety Harbor Register
May 5 Girls on the Run 5k, St. Pete Register
May 5 Hog Hustle 5k, Dunedin Register
May 5 May Day 5k, St. Pete Register
May 6 Bare Dare 5k, Land O Lakes Register
May 6 Xterra the Claw 10m/5m Adventure Run, Alafia Register
May 12 The Great Mother’s Day Race 5k, Sarasota Register
May 13 I Love Mother’s Day 5k, Palm Harbor Register
May 13 The Great Mother’s Day Race 5k, Tampa Register
May 19 ★Run for All Children 10k/5k, St. Pete | RUN TAMPA GROUP EVENT★ Register
May 19 Busch Gardens Run for the Fund 5k, Tampa Register
May 19 Hippie Dash 8k/5k, Gulfport Register
May 19 LPF Fallen Heroes Memorial 5k, Lakeland Register
May 26 Honor Our Heroes 5k, Oldsmar Register
May 26 Honor Our Heroes Memorial Run 5k, Safety Harbor Register
May 27 ★ Boston Run to Remember Half Marathon /5mi RUN TAMPA GROUP EVENT ★
un 2 Best Damn Leftover 5k, Safety Harbor Register
Jun 8 WFYRC Summer Series #1, Sand Key Park, Clearwater
Jun 9 RAP River Run 5k/10k, New Port Richey Register
Jun 9 RAP River Run 5k/10k, New Port Richey Register
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Jun 16 Great Father’s Day Race 5k, Sarasota Register
Jun 17 ★Richard’s Father’s Day Family Walk/Jog, Tampa RUN TAMPA GROUP EVENT★ Register
Jun 17 I Love Father’s Day 5k, Palm Harbor Register
Jun 17 The Great Father’s Day Race 5k, Tampa Register
Jun 22 St. Pete Beach 5k Race #1 Register
Jun 22 WFYRC Summer Series #2, Sand Key Park, Clearwater
Jun 30 Moon Over Croom 21m/14m/7m Trail Run, Brooksville Register
Jul 3 Kiwanis Midnight Run 10k/5k, Dunedin
Jul 4 Independence Day Hot Dog 5k, Clearwater Register
Jul 4 Lutz Independence Day 5k
Jul 13 WFYRC Summer Series #3, Sand Key Park, Clearwater
Jul 20 St. Pete Beach 5k Race #2 Register
Jul 27 WFYRC Summer Series #4, Sand Key Park, Clearwater
Aug 17 St. Pete Beach 5k Race #3 Register
Sep 15 Great Gay 5k, St. Pete Beach Register
Sep 15 St. Jude Run to End Childhood Cancer, Tampa Register
Sep 22 PB & J 10k/5k, Clearwater Register
Sep 22 Tick Tock Ultra, Lakeland Register
Oct 13 Ronnie’s Run 10mi/5k, Ft. Desoto Beach Register
Oct 13 Tampa Police Memorial Run Register
Oct 13 Whiskey Run Half/10k/5k Race Across the Bay Register
Oct 20 East Lake Fire Rescue 5k, Palm Harbor Register
Oct 20 Live for 24 5k/mile Fun Run, Tampa Register
Oct 27 Great West Chase 10k/5k, Tampa Register
Nov 2 ★ Richard’s Run for Life 5k, Ybor City | RUN TAMPA GROUP EVENT ★ Register
Nov 4 Buddy Run 5k, Tampa Register
Nov 10 ★ Myakka River Half/10k/5k, Sarasota RUN TAMPA GROUP EVENT★ Register
Nov 10 Phil Doganiero 3 Bridge Clearwater Register
Nov 17 Sunshine City 5k, St. Pete Register
Nov 18 ★ St. Pete Run Fest Half Marathon | RUN TAMPA GROUP EVENT ★ Register
Nov 22 Goody Goody Turkey Gobble 8k/5k/1mi, RUN TAMPA GROUP EVENT ★ Register
Nov 22 Tampa Bay Times Turkey Trot 10k/5k, Clearwater
Nov 23 Waterset 5k, Apollo Beach Register
Dec 8 Hillsborough River Marathon/Half/Quarter Register
Dec 8 Miles for Moffitt, Tampa Register
Dec 8 Santa’s Reindeer 10k/5k Run, New Port Richey Register
Dec 9 Holiday Halfathon & Relay, Madeira Beach Register
Dec 15 Iron Sharpeners 5k, Al Lopez Park, Tampa Register
Dec 16 Hot Chocolate 15k/5k Run, Tampa Register
Dec 22 ★ Run Tampa Tinsel Run 5k/1mi, Al Lopez Park | RUN TAMPA GROUP EVENT ★
Dec 29 Manatee River 5 Mile & State Championship Register
Jan 19/20 ★ St. Pete Beach Classic 5k/10k/Half/Beach Run|RUN TAMPA GROUP EVENT★
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We have three runs per week, the main being on Saturday and Sunday. All paces welcome. No pressure to hang with a pack. No minimum distance. Any distance possible at every location. You fall in with whomever is going your pace, and before you know it, you have many new friends. Click here for a whole list of maps for various trail runs, our regular runs, plus others.
Saturday Runs, 7-9 a.m.
Check details below. Occasionally we don’t have a run due to a race or Saturday locations may need to be switched for one month.
1st Saturday: Trout Creek ($2 park fee) (map) (off road trails/hard-packed dirt/asphalt)
2nd Saturday: Upper Tampa Bay Trail (map) (asphalt with water kiosks & restrooms)
3rd Saturday: Safety Harbor (map) (sidewalk and asphalt)
4th Saturday: Upper Tampa Bay Trail (map)
5th Saturday, when there is one: Wild card. Sometimes, no run. Check schedule below.
Sunday Runs, 7-8 a.m.
Check details below. Sometimes we don’t have a run due to the club participating in a race.
We meet at the fountain in the Hyde Park Village courtyard, then run the spectacular Bayshore, before regrouping for breakfast at Goody Goody Burgers, a block away. Free parking. Click here for map. Water drop at 2-miles. Some turn around there; others continue for more miles. Maps here. Click here to read a detailed description.
Group Run Details
April 5, Thursday, 8:30 a.m. Lake Rogers Park Trail Run
April 7, Saturday, 7 a.m. Trout Creek Park
April 8, Sunday, No group run due to group race, **Iron Girl, Clearwater**
April 12, Thursday, 8:30 a.m., Lake Rogers Park Trail Run
April 14, Saturday, 7 a.m., Upper Tampa Bay Trail; meet in lot behind Citrus Park Cyclery
April 15, Sunday, 7 a.m., Goody Goody Bayshore Run; meet at Hyde Park Village fountain
April 19, Thursday, 8:30 a.m., Lake Rogers Park Trail Run
April 20, Friday, 7:00 p.m., No group run due to group race, **Roar Through Ybor**
April 21, Saturday, no group run due to Friday night race
April 22, Sunday, 7 a.m., Goody Goody Bayshore Run; meet in Hyde Park Village fountain
April 26, Thursday, 8:30 a.m., Lake Rogers Park Trail Run
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Run Tampa Group Runs
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