




In Phoenix, Arizona, a 26-year-old mother stared down at her 6 year old son, who was dying of terminal leukemia. Although her heart was filled with sadness, she also had a strong feeling of determination.
Like any parent, she wanted her son to grow up & fulfill all his dreams. Now that was no longer possible...The leukemia would see to that. But she still wanted her son's dream to come true.
She took her son' s hand and asked, 'Billy, did you ever think about what you wanted to be once you grew up? Did you ever dream and wish what you would do with your life?'
'I wanted to be a fireman when I grew up,' he said. Mom smiled back and said, 'Let's see if we can make your wish come true.'
Later that day she went to her local fire Department in Phoenix, Arizona, where she met Fireman Bob, who had a heart as big as Phoenix. She explained her son's final wish and asked if it might be possible to give her 6 year-old son a ride around the block on a fire engine. Fireman Bob said, 'Look, we can do better than that. If you'll have your son ready at seven o'clock Wednesday morning, we'll make him an honorary Fireman for the whole day. He can come down to the fire station, eat with us, go out on all the fire calls, the whole nine yards! And if you'll give us his sizes, we'll get a real fire uniform for him, with a real fire hat - not a toy - one-with the emblem of the Phoenix Fire Department on it, a yellow slicker like we wear and rubber boots.'' They're all manufactured right here in Phoenix, so we can get them fast.'
Three days later Fireman Bob picked up Billy, dressed him in his uniform and escorted him from his hospital bed to the waiting hook and ladder truck. Billy got to sit on the back of the truck and help steer it back to the fire station. He was in heaven. There were three fire calls in Phoenix that day and Billy got to go out on all three calls. He rode in the different fire engines, the paramedics' van, and even the fire chief's car. He was also videotaped for the local news program.
Having his dream come true, with all the love and attention that was lavished upon him, so deeply touched Billy that he lived three months longer than any doctor thought possible. One night all of his vital signs began to drop dramatically and the head nurse, who believed in the hospice concept - that no one should die alone, began to call the family members to the hospital.
Then she remembered the day Billy had spent as a Fireman, so she called the Fire Chief and asked if it would be possible to send a fireman in uniform to the hospital to be with Billy as he made his transition. The chief replied, 'We can do better than that. We'll be there in five minutes... Will you please do me a favor? When you hear the sirens screaming and see the lights flashing, will you announce over the PA system that there is not a fire?'' It's the department coming to see one of its finest members one more time. And will you open the window to his room?'
About five minutes later a hook and ladder truck arrived at the hospital and extended its ladder up to Billy's third floor open window-------- 16 fire-fighters climbed up the ladder into Billy's room. With his mother's permission, they hugged him and held him and told him how much they LOVED him. Billy looked up at the fire chief and said,'Chief, am I really a fireman now?'
'Billy, you are, and The Head Chief, Jesus, is holding your hand,' the chief said.
With those words, Billy smiled and said, 'I know, He's Been holding my hand all day.' He closed his eyes one last time.
*This is a true story,one that touched my own heart so, so much
Lisa
Perhaps the most common and most frustrating overuse injury in runners is chronic heel pain that just won't go away! (Achilles tendonitis is a close second!) It seems all of us have either experienced this nagging injury or knows someone who suffers from it. This article will give you the nitty-gritty on plantar fasciitis:
Just remember: nothing can take the place of a good sports physician or podiatrist.
Let’s start with the basics.

What plantar fasciitis is…
The plantar fascia is a strong ligament which lies just beneath the skin on the plantar surface of the foot. It extends from its attachment at the heel distally to the toes. Its purpose is to provide integrity to the bottom of the foot and allow some "spring" action in the push off phase of gait.
The plantar fascia works very closely with the calf muscles and Achilles tendon. The tighter your calf muscle, the more strain is placed on the Achilles tendon and plantar fasciia. The reason your heel hurts worse in the morning is that when you sleep, your foot is plantarflexed (toes point down) a bit. This causes the calf muscle to tighten which in turn causes the Achilles tendon and plantar fascia to tighten. When you first step on the floor in the morning, the tight plantar fascia is suddenly stretched causing pain. The patient with plantar fasciitis typically complains of pain first thing in the morning. This pain usually goes away after a few steps, only to return after a period of inactivity such as driving to work. We runners have a tendency to ignore small aches and pains. However, if you ignore heel pain, it will likely become worse and therefore much more difficult to heal.
What plantar fasciitis isn't…
If your heel is always painful especially with weight-bearing, and there is pain when you cup your heel with your hand and squeeze, then you may be suffering from a stress fracture of the calcaneus (heel bone). Time to get an X-ray or bone scan.
If you experience a tingling sensation like a mini electrical shock in your arch and heel, then a condition called tarsal tunnel syndrome may be the cause of your pain. This is the foot version of carpal tunnel syndrome where a ligament becomes very tight across a nerve causing the tingling. This is usually caused by excessive pronation and is often cured with an orthotic.
Pain in the medial arch is often confused with plantar fasciitis, but is usually an inflammation of the posterior tibial tendon. Lastly, chronic back pain due to arthritis of the lower back can cause referred pain in the heel. A sports medicine physician or podiatrist should be able to diagnose your condition and get you back running again.
How to cure plantar fasciitis.
Plantar fasciitis by definition is caused by inflammation of the ligament. Initial treatment consists of early recognition of the problem and reducing the inflammation. Ice, stretching and anti-inflammatory medications can help in the early stages of plantar fasciitis. Try and look back over your training log to see if your training changed which may have caused this overuse injury:
If ice, stretching, ibuprofen, and change in running shoes do not resolve your symptoms, an orthotic may be necessary to reduce the pronation or flattening of your foot. These do not have to be expensive. While some patients will require a custom orthotic made from an impression of their feet, most patients do quite well with off the shelf orthotics such as the "Sole Orthotic". These are heat- moldable inserts which run about $50. They can be found in most running stores or at Zombie Runner (I have no financial interest in anything!).
A night splint may also be beneficial. This is a brace which holds your foot at 90 degrees thus gently stretching your achilles tendon and plantar fascia. Patients find the splint is very easy to wear especially when reading, watching TV or sleeping. I find the dorsal night splint to be the most comfortable. Google "night splint for plantar fasciitis" for a listing of suppliers.
Massage therapy and physical therapy are also beneficial in reducing the inflammation and relieving the tight plantar fascia. Injection therapy is an option if the above does not relieve your symptoms. While I am against injecting a steroid directly into a tendon, I do often inject the plantar fascia. The injection will usually reduce the inflammation to a point where conservative measures can now work more effectively. Again, the key is reducing the inflammation.
Surgery is sometimes necessary to resolve plantar fasciitis which is not improving with any of the above treatment measures. Only about 5% of patients require surgery. In general there are two types of surgical procedures:
The first is aimed at cutting part of the plantar fascia thus elongating the ligament (picture cutting through one half of a large rubber band).
The other surgery involves no incision, but rather a series of shock waves is applied to the heel. The body does not respond to chronic inflammation very well, however it does respond quite well to acute inflammation. The shock wave therapy is aimed at changing the chronic inflammation into acute inflammation so the body can begin to heal.
How to avoid a recurrence
OK, so now you have finally gotten rid of the dreaded plantar fasciitis, how can you stop it from recurring? As always, watch your training, stretch gently and replace your shoes when needed. Having said all that, I have become a big advocate of running barefoot for short periods of time each week. When a foot is encased in a supportive shoe with a heel, the muscles of the foot do not have a chance to strengthen. Try standing on one foot without shoes. Do you wobble a lot? This may be due to weak muscles in the foot. Running shoes with a high heel can predispose a runner to achilles tendonitis and plantar fasciitis by shortening these tendons and ligaments. I am not saying get rid of your favorite shoes! I am suggesting gently running a half mile or so barefoot on a soft surface once or twice a week. This will strengthen muscles you never knew you had as well as teach you to run gently thus allowing your foot and leg to absorb shock rather than relying on the shoe.
Remember: early recognition of the symptoms is key to healing quickly!
Previous articles from Dr Chris:
Chronic Achilles Tendonitis





This is definitely the "queen stage" of the whole ride, with plenty of rollers, long flats through the desert, a massive climb, and a massive descent at the end down into Death Valley. And much of it will be ridden in the dark, whew. Not to mention an uneven road surface through the Panamint Valley.
Actually, she passed that a while ago (at 3:43 PM) but it's such a nifty thing to be able to spot her whereabouts on a map that I just had to share it with y'all.
And yes-- it's true. Cathy Cramer doesn't even need to open her eyes to crew. She's that good, folks. = Lisa's 810 has raised half a million dollars =
FROM LISA: I learn so much from each of my students…including Dr. Christiane Gardner.
Christiane is a new student and I plan to help her get back into the best shape of her life. Chris has an amazing background… she was a member of the National Cross-Country Championship team for two years in a row, she won the junior national 30km championship in 1978, and more recently she coached Camden Hills Regional Hills School girls XC team from 1999-2004. I feel honored to be coaching Dr. Chris!
In addition to her running talents, Christiane is board certified by the American Board of Podiatric Surgery and the American Board of Podiatric Orthopedics. From 1990-1992, she was the Assistant professor of podiatric sports medicine and biomechanics at the Ohio College of Podiatric Medicine. From 1992-2008, Chris led a private practice in Rockport, Maine. And currently, Chris serves as the Chief of Podiatry Service and Director of Podiatric Medical Education, VA Eastern Kansas Health Care System.
Christiane has offered to talk to any students who are having feet trouble and she has already helped a few! Thank you, thank you!
And here are some thoughts from Christiane about a condition you may have experienced…and ways for you to avoid it.
Chronic Achilles Tendonitis
By Dr. Christiane Gardner
It is estimated that achilles tendonitis accounts for 11% of all running injuries. This percentage increases as the runner ages. If you are reading this, chances are you have suffered from achilles tendonitis.
First, a short anatomy lesson. The achilles tendon is the largest and most vulnerable tendon in the body. It joins the calf muscle (gastrocnemius and soleus) to the heel of the foot. This muscle - tendon complex is responsible for plantarflexion of the foot and is what allows us to propel ourselves forward while running. While tendons are strong, they are not very flexible and they can only go so far before they become inflamed and tear or rupture. Unfortunately, the achilles tendon has poor blood supply which is why it is so slow to heal.
What causes Achilles Tendonitis?
The biggest cause of chronic achilles tendonitis is ignoring early warning signs and pushing through the pain of early achilles tendonitis. If the achilles tendon is sore, you need to pay attention to it immediately!
Other causes include:
· Increasing mileage too soon;
· Excessive hill running;
· Sudden addition of speed work;
· And/or wearing running shoes past their expiration date (see below)
Biomechanically, excessive pronation or flattening of the medial arch can cause achilles tendonitis. When the foot flattens too much or stays flat for too long, the achilles tendon is twisted abnormally. Over time, this twisting can cause microtears in the tendon leading to inflammation and even further damage. Imagine a tight rope where a few fibers begin to unravel and you get the idea. Worn running shoes can also lead to achilles tendon issues for the same reason.
Symptoms
Symptoms of acute achilles tendonitis include:
· Pain of the tendon during exercise
· Swelling of the tendon
· Feeling a "creaking" sensation within the tendon as you move the foot (this is swelling of the tendon sheath).
If acute achilles tendonitis is not treated, chronic achilles tendonitis often follows.
Symptoms of chronic achilles tendonitis include:
· Pain and stiffness in the tendon especially in the morning
· You may feel nodules within the tendon, usually about 2 cm above the heel
· Pain in the tendon especially when climbing stairs or walking up hill
This pain can be a long term persistent problem
Treatment
The best treatment is to listen to your body. If your achilles tendon becomes painful, cut back on your activity, stop running hills and ice, ice, ice! If you can treat this problem early, you reduce the pain and frustration of dealing with chronic achilles tendontis!
Replace your running shoes if they have seen better days.
Place a temporary heel lift in both shoes. This will take the strain off the tendon. Once the tendon is not painful, remove the lifts.
Careful, gentle stretching can help but too much stretching or too aggressive a stretch can contribute to the problem. Please do not stretch your achilles tendon by hanging your heel off a stair. It is difficult to control the stretch, and if the tendon is already inflammed, you may risk tearing the tendon.
Once you have tried the above and are frustrated with your progress, it is time to seek help from a sports injury professional. Physical therapy may be needed to strengthen the calf muscles. Ultrasound and massage therapy may be indicated. New running shoes or orthotics may be needed to reduce pronation.
Please do not allow anyone to inject the achilles tendon with cortisone. Medical literature has many cases of complete achilles tendon ruptures after direct injection of cortisone into the tendon.
Many articles have been written on the beneficial effects of eccentric exercises in the treatment of achilles tendonitis. In this exercise, stand with your hands on a railing or desk for support, using your good leg, rise up on your toes, now put your injured leg down toes first, transfer your weight to the injured leg and SLOWLY lower your body down until your affected foot is flat on the ground. Repeat this 10 times.
In summary, chronic achilles tendonitis can be frustrating and seem to take forever to heal. You can reduce your chances of developing this and other injuries by listening to your body. A few days off in the early stages of an injury can prevent months of seemingly endless rehab!