Plantar Fasciitis

Plantar Fasciitis literally means inflammation of the plantar fascia. The plantar fascia is a thick band of rigid tissue that extends from your heel to your toes. The function of this fascia is to help your foot transition from the shock absorption phase (heel contact to foot being flat) to becoming a rigid lever for push off as the heel rises and the toes bend.

 

Plantar fasciitis is one of the more common and troublesome injuries among runners. It is characterized by pain in the heel and / or arch. You will often feel the pain with the first few steps in the morning or when beginning to walk after sitting for a while. Initially, the pain may ease as you warm up into your run. If you have a mild case you can usually continue training, a more stubborn case needs rest (see Cross Training ).

 

Treatments:

  • See Principles of Recovery Very important!.
  • Lots of stretching! Research has demonstrated that the plantar fascia stretch is more effective than calf stretches. In my experience it is essential to perform the plantar fascia stretch, as well as the bent knee calf stretches and straight knee calf stretches two to three times per day. Also, perform a non-weight bearing calf stretch before walking or getting out of bed (as much as practically possible). By improving calf flexibility there will be less strain on the plantar fascia.
  • Ice massage is a very effective way to help reduce your pain and is described in Principles of Recovery”. Another ice massage technique is to use a frozen water bottle or orange. Place the bottle / orange on the floor and roll it under your foot until the bottom of your foot goes numb. The orange is nice because the massage is a little more focused and the bottle is nice because it is very cold.
  • Self-massage can be quite helpful, especially before getting out of bed or before a run. I prefer a technique where you use the heel of your hand to massage across the arch while flexing the big toe with your other hand (see plantar fascia massage).
  • Insoles or orthotics (custom foot supports) may be able to position the foot in a way that reduces strain on the plantar fascia. My favorite insoles are Sorbothane insoles because they have nice arch support and outstanding cushioning that lasts for years. Avoid walking barefooted during the painful phase.
  • I find that a frequent rotation of three quality shoes is helpful. Most people like a pair of running shoes, a pair of semi-rigid clogs (Dansco shoes are excellent-check them out at Shoes.com), and a pair of Birkenstock type sandals.
  • Research has demonstrated that the use of a night splint to hold the foot in a stretched position while sleeping improves plantar fasciitis. Originally, patients were asked to sleep in a rigid boot. After sleepless nights, injured spouses, and discarded boots, the Strassburg sock (see thesock.com) came along. This is a much more comfortable approach to the night splints. In my experience, night splints are helpful for people who experience pain with the first steps in the morning and have had symptoms for more than a month.
  • Balanced Solution DVDStrengthening and balance training are seldom emphasized but are an extremely important component of recovery. Greater muscular strength and balance will reduce strain on the plantar fascia and provide an environment for optimal healing. The Injured Runner – A Balanced Solution DVD includes exercises that both stren gthen the foot and will improve your balance. These exercises are particularly helpful after your symptoms have improved.
  • If you have put on some extra weight, this could be good incentive to watch your diet and cross train. When your heel is sore it is harder to find a good exercise to assist with weight control but weight loss can really make a difference.
  • Walking barefoot in grass for 2-4 minutes after the initial painful period has subsided can be helpful to progress to the next level. This works for a couple of reasons. First, walking on soft grass genlty bends and twists your foot stretching in ways that help workout tight muscles in the foot. Second, the gentle bending and twisting also strengthens the small muscles in the foot.
  • Running form may also contribute to plantar fasciitis. Review our running form page to see if you can make any improvevments to your form. This is especially important if you have been limping for awhile.
  • Butt strengthening exercises are importand because you will lose strength in the gluteal muscles since you cant push off as firmly. This may lead to other injuries down the road (no pun intended)..
  • If none of this helps, find a good orthopedic surgeon that specializes in feet to discuss the possibility of injections or surgery.

Considerations: Some arthriticconditions may have similar symptoms. Talk to your doctor if you are concerned about this.