If you follow me on Instagram, then you likely know that I have spent half of 2021 battling a plantar fascia tear. I’m happy to report that thanks to PRP injections, my torn plantar fascia is HEALED.
I have gotten a lot of questions over Instagram and Facebook about my injury and how I healed it, so I figured it was time to share my experience with PRP injections on the world wide web. Frankly, there isn’t a lot of information from real people on the relatively novel treatment so I want to fill the void and give hope to the hopeless. To be honest, this injury was incredibly painful and I never thought I would get better!!
(Buckle up: this is a LONG one that I hope is helpful to anyone battling this persistent running injury!).
How I got my plantar fascia injury
A quick recap: In August of 2019, I partially tore my hamstring on a marathon build-up with hopes of qualifying for the Olympic Trials marathon. I still ran the marathon in 2019, tried to continue to train after, and finally called it quits on February 1 of 2020 spending the rest of the year rehabbing the hamstring tear and resulting in high hamstring tendinosis.
I finally resumed training in January of 2021. I had a successful build-up but did have some nagging heel pain that seemed to come and go.
In April, three days before I was set to run my first race, I got my second COVID-19 vaccine. Twelve hours later I was in the ER and diagnosed with pleurisy. I took 6 weeks off running to let my lung inflammation go down. (It is possible but not confirmed this was an adverse vaccine reaction).
I remember taking steroids hoping a fringe benefit would be to resolve my heel pain.
When I resumed running, I focused on very easy running, getting a chest strap heart rate monitor to ensure I kept my heart rate low.
The heel pain persisted.
On July 4 while on a beach vacation, I set out for a 16 to 18 mile long run with hopes that it would loosen up. I promised myself that I would not alter my form to protect my heel. Still, I ignored cues that I needed to stop and ran 14 miles before I could not run any further.
Cutting a run short was a first for me.
How I mistook a plantar fascial tear for plantar fasciitis
I felt sure I had plantar fasciitis and made an appointment with my physical therapist as soon as I got back from the beach. I had all the signs. It was in the right spot. I could not stand in the morning, etc.
My PT diagnosed me with plantar fasciitis and Achilles tendonitis and we treated it as such. I did lots of calf stretching and rolling. I did toe yoga and foot strengthening. I bought a MOBO board. She scrapped my foot and performed other manual therapies. I slept with a night splint. I bought a bunch of shoe inserts and running shoes.
I completely stopped running and biked instead. I didn’t lift heavy weights because heavy loads aggravated it. I wore Oofos or running shoes all the time (even to a wedding). I massaged, scrapped, and cupped it. I iced and heated all day long. And, when that didn’t work, I got a cortisone shot.
Two weeks after the cortisone shot, I attempted a couple of runs on the alter-G anti-gravity treadmill. When that felt okay, I tried a couple of walk/runs on the road. I felt like the pain would numb after the first couple of miles but one day I couldn’t make it home and had to be picked up.
Yet, another first for me.
It was at this point I accepted the heel injury wasn’t getting any better despite my best efforts and delusion that it was. It was time to get it imaged.
How I was diagnosed with a plantar fascia tear along with plantar fasciitis
In addition to the fact that my heel pain wasn’t improving, I was getting intense achy pangs while walking, stretching, or even just sitting down. These pangs were like what I got with my hamstring injury. This was another clue that I may have a tear.
So, I got a diagnostic ultrasound. I chose an ultrasound instead of an MRI because it was faster, cheaper, and the doctor can go over the imaging with you as he or she does it.
My doctor was able to show me where the plantar fascial tear was, how large it was (40 percent torn), plus a bone spur and heel spur that were further aggravating the tissue. He was also able to show me how much inflammation was in my foot, a sign of plantar fasciitis.
How I decided to get PRP injections for plantar fasciitis and my plantar fascial tear
Thus, I was diagnosed with both plantar fasciitis and a significant plantar fascia tear.
Being injured is very confusing. People, including medical professionals, have all sorts of opinions and others like to share their experiences, including negative ones. I have to say, I got very annoyed by people telling me they had the “same injury” and “it never went away” and/or “x treatment” didn’t work for them. I’m sorry for your pain but that’s not helpful when trying to navigate these murky waters.
To decide whether I should do a PRP injection I did my own research on the efficacy, talked with others (similar runners and experienced running coaches) who had done it, and talked with my doctor who I trusted. Finding a medical professional who understands runners and has your best interest at heart is paramount. I am lucky that I have found that.
Before I was diagnosed with the plantar fascial tear, I had considered PRP injections for my plantar fasciitis. The research (including this 2016 study, this 2011 study, this 2012 study and this one, and this 2014 study) weren’t super convincing and also very limited. (Basically, it showed PRP was a promising treatment as compared to cortisone shots).
When I learned my PF was torn, I viewed PRP as the only option to get better.
It couldn’t hurt (well, literally, yes it COULD). And it was a better option than plantar fascia surgery—which in effect cuts the plantar fascia anyway. That’s already been done for me.
What are PRP injections and how do PRP injections work?
PRP stands for Platelet Rich Plasma, a treatment that uses your own blood cells to accelerate healing. How? Because plasma, a component of your blood, with extra platelets in it leverages the power of platelets, a type of blood cell, to trigger cell reproduction and tissue regeneration.
To create platelet-rich plasma, clinicians take a blood sample from the patient and place it into a device called a centrifuge that rapidly spins the sample, separating out the other components of the blood from the platelets and concentrating them within the plasma.
A clinician draws blood, spins it quickly in a centrifuge to separate the platelet-rich plasma, and then injects that PRP into the injured area using diagnostic ultrasound imaging to guide the needle to the right spot.
Watch a video of my PRP-injection.
Do PRP injections hurt?
Warning: without numbing medication, the PRP injection is painful. Like, worse than childbirth pain—particularly because the injured area is already incredibly sensitive. Even the lightest touch of my heel was painful. The PRP shot was much more painful than the cortisone shot.
Why do PRP injections hurt so much? I think it is because the needle goes deep into an already sensitive area and then the doctor moves it around to make sure the PRP reaches the entire injured area. It hurt and when I didn’t think it could hurt anymore, he’d move the needle and jab it further, and it hurt more. I needed crutches to walk out of the office.
For my second and third shots, I went in a half hour early so they could apply a topical numbing cream which helped a lot. I also had something to squeeze and a nurse tapped me to help distract me from the pain. All these measures made it more tolerable.
How much are PRP injections?
PRP injections cost about $250 per injection and are not covered by insurance. If you buy more than one, there is a chance your clinician will give you a discount. I was able to save about $10 per PRP injection when I bought a series of three.
Who can perform PRP injections?
A podiatrist performed my PRP injection. A sports physician or orthopedic may also perform a PRP injection for plantar fasciitis or a plantar fascia tear. I recommend searching “PRP injections near me.
How long does a plantar fascia tear take to heal?
After three PRP injections, it took a total of 4 months for my plantar fascia tear to heal. It took another six weeks to gradually ease back into running starting with running on the alter G treadmill then run/walk on the road.
My plantar fascia tear treatment plan:
Once I was diagnosed with a plantar fascia tear, I dramatically changed my treatment.
When I thought I had plantar fasciitis, I was doing a lot of manual therapies, icing and heating, stretching, and strengthening. When I learned I had a PF tear I did the following:
- I wore a boot for 6 weeks. For two weeks, I gradually weaned off wearing the boot.
- I stopped all manual therapies and stretching. I rested and let it heal.
- I did 1 PRP injection every month. After each injection, I would do total rest (no biking or weight lifting) for a total of 3 days.
- After two months, I was able to go from biking to weight-bearing on the elliptical. Then I was able to walk, run on the alter-g treadmill, and transition to run/walk 5 months after my PRP injection.
- Every week, minus 10 days after a PRP injection, I would see a physical therapist who performed manual therapies to allow the PRP injection to fully reach the entire injured area. This included massage, cupping, and western dry needling with electricity. He also gave me exercises to strengthen my foot and glute.
- My physical therapist also designed orthotics to address my foot biomechanics issues.
Do PRP injections heal plantar fasciitis and a torn PF?
Yes, I feel confident in my personal experience that PRP helped heal my plantar fasciitis and PF tear.
After each injection, the tear healed more. It’s also important to note that the healing rate accelerates EXPONENTIALLY after each PRP injection. Thus, I saw my tear shrink faster and my inflammation reduced more after each PRP shot.
- One month after my 1st PRP injection my tear went from 40 percent torn to 35 percent torn.
- One month after my 2nd PRP injection, my tear went from 35 percent torn to 20 percent torn.
- One month after my 3rd PRP injection, my tear went from 20 percent torn to less than 5 percent torn.
- Two months after my 3rd PRP injection and 5 months total, I had almost no heel pain.
It took a total of 6 months of rest, rehabilitation, and no running to heal my plantar fasciitis and PF tear.
How long do PRP injections last?
The PRP injection will last for 6 to 9 months, continuing the healing process long after the last shot.
How long does it take for PRP injections to heal?
My PF was sore for several days up to a week after the PRP injection. It started to feel markedly better about two weeks after each PRP injection.
What caused my plantar fascia tear?
When you are dealing with a running injury, it’s paramount you identify the cause so you aren’t shadowboxing injuries.
My physical therapist was able to determine that I have the beginning of hammertoes in my right foot. This resulted in extra stretching of the plantar fascia when I run. It also caused extra torque on my leg while running which weakened my glute and led to a compensatory quadriceps injury.
The hammertoes also potentially led to my hamstring tear in 2019.
Thus, he prescribed custom orthotics and exercises to address biomechanical issues, muscle imbalances, and weaknesses.
5 Lessons from my Plantar Fascia Injury
Each running injury holds a host of lessons. I round-up several from my hamstring injury. My plantar fascia injury also taught me many things.
Instead of wasting my time treating the wrong injury (plantar fasciitis), if I had my injury imaged, I could have started the PRP injections and healing process two months sooner. If you don’t see any improvement after a couple of weeks, get your injury imaged. Also, it may be time to try a new treatment.
Find a medical pro you can trust.
I had so many medical opinions and personal experiences thrown my way on how to treat my injury. Finding a medical professional who knows me, runners, and has my best interest at heart (not dollar signs) was crucial. Ask around for doctor and physical therapy recommendations from people you trust.
Throw out timelines and be patient.
Don’t try to stick to a healing timeline. Try to focus on the day-to-day. Your number one goal is healing. Running and races will always be there.
Listen to other people’s stories with caution.
Try not to let other people’s injury stories get you down. I remember the day I decided to try PRP injections, a lady in a running store felt the need to start chatting with me about my boot, her plantar fascia tear, and how PRP injections didn’t help her.
Their stories are not your stories. There are too many variables that it is never apples to apples. Plus, you never know how committed to recovery these people are.
Get multiple PRP injections.
I’ve had a lot of people reach out to me, saying PRP injections did not work for the plantar fascia tear and plantar fasciitis. Then I learned they only got one. You likely need a series of PRP injections (an average of 3 PRP shots) for the PF tear to heal.
If you have any questions about my injury and experience with PRP, email me at [email protected]!