Neil - I'm looking for some advice on a rehab plan to get myself back to the 50 mile running weeks I enjoyed before my bout of plantar fasciitis. Ibuprofen has been working for the pain and after a month off I am pain free without the ibuprofen until I walk a couple miles. Is it ok to take Ibuprofen before a run? Am I risking re-injury if I run with some pain? Now that I have not ran for a month, how many weeks and what rate of mileage increase do you recommend to return to my previous level? Thank you for your response.
Plantar fasciitis is a real bear. Quite often, it can seem to be resolved, and as soon as you take that first step, it can be back at square one! If you can only walk a couple of miles, I don't anticipate your return to running anytime soon, especially not 50 mile per week. We have had some success treating plantar fasciitis in our clinic using two devices. One is a custom orthotic with a plantar fascia accommodation (a groove in the device that runs along the medial side of the device to accommodate the tight tissue). The other is a dorsi-flexion night time slpint. This is a pain to sleep with, but it keeps the tissue stretched out at night, so that when you stand on it in the morning, you do not tear the tissue again. By using these two devices, you can stop re-injuring the tissue, and actually allow it to heal. Once three weeks of PAIN FREE walking has past, then we allow our patients to begin walk/jog training.
Mileage increases are entirely dependent on pain during and after exercise. We ask our patients not to exercise before three hours have passed in order to gauge the effect on the connective tissues. Once you are adding mileage without pain, do so on a gradient - one additional mile per week.
As far as your question about ibuprofin is concerned, please consider the following thoughts: Ibuprofin is a non-steroidal anti infammitory drug. It delivers on it's promise by inhibiting the formation of prostoglandin E, type 1. This molocule is manufactured as a by-product of cell membrane failure, and is both a stimulant of inlfammation (by activating macrophages - scavenger cells) and at the same time a neurotransmitter for pain. Ibuprofin needs to be taken at theraputic doses to inhibit the formation of the molocule. At low dose, it functions as an analgesic, temporally masking pain. So I wouldn't use it prophylactically unless I was using it as a theraputic dose (2400-3200mg/day-check with your medical doctor)