From treatment to prevention, here are the facts about this common running injury.
Plantar fasciitis is a condition caused by drastic or sudden increases in mileage, poor foot structure, and inappropriate running shoes, which can overload the plantar fascia (the connective tissue that runs from your heel to the base of your toes), resulting in heel pain.
The plantar fascia may look like a series of fat rubber bands, but it’s made of collagen, a rigid protein that’s not very stretchy. The stress of overuse, overpronation, or overused shoes can rip tiny tears in it, causing heel pain and inflammation, also known as plantar fasciitis.
Identifying Plantar Fasciitis Symptoms
Plantar fasciitis sufferers feel a sharp stab or deep ache in the heel or along the arch of the foot, according to Dr Jordan Metzl, a sports medicine physician and creator of Runner’s World’s IronStrength workout.
Another sign of the condition is the morning hobble you may experience from your foot trying to heal itself in a contracted position overnight. Taking that first step out of bed causes sudden strain on the bottom of your foot, resulting in pain in your heel or arch. The pain can recur after long spells of sitting, but it tends to fade during a run once the area is warmed up.
A third symptom is pain experienced during push off while running.
Common Causes of Plantar Fasciitis
Plantar fasciitis-related heel pain tends to strike those who overtrain, neglect to stretch their calf muscles, or overdo hill work and speedwork. “When you have very tight calf muscles, they will pull on the plantar fascia and cause a lot of pain,” Metzl says.
The condition of plantar fasciitis can also be caused by biomechanical issues, including flat feet with high arches or excessive pronation. A sudden in crease in training mileage or beginning speed training, wearing worn running shoes, running on hard surfaces like asphalt or concrete can also lead to plantar fasciitis. Wearing high heels all day and then switching into flat running shoes may also cause the issue.
Plantar Fasciitis Treatment
Plantar fasciitis can be a nagging problem, which gets worse and more difficult to treat the longer it’s present.
“When the fascia comes off the bone, it gets chronically inflamed and can heal exceptionally slowly,” Metzl explains. “Plantar fasciitis can be sore for months because the healing response is proportionate to blood flow. When something has a good blood supply like a muscle, it heals quickly, but the plantar fascia essentially has no blood supply so it can take longer to heal.”
As the first step in treatment of the condition, reduce swelling. Metzl recommends sticking your foot in an ice bucket or freezing a bottle of water and rolling your foot with it. You can also massage the foot with a golf ball.
What shoes you wear when you’re not running also makes a difference. Arch support is key, and walking around barefoot or in flimsy shoes can delay recovery.
If pain is present for more than three weeks, see a medical professional about the problem. Treatment options such as orthotics, foot taping, cortisone injections, night splints, and anti-inflammatories decrease symptoms significantly in about 95 per cent of sufferers within six weeks.
For more stubborn cases, physical therapy or shock-wave therapy may be prescribed. Increasingly, doctors are looking at platelet-rich plasma (or PRP), in which a doctor takes blood out of your arm, spins it down, takes out the platelets, and injects them into the fascia, for cases that aren’t getting better.
For some runners who continue to experience symptoms even after treatment, a medical remedy in the form of surgery is sometimes necessary. Your doctor would need to consider several factors, including your overall health and medical history, before deciding to go the surgery route.
Preventing Plantar Fasciitis
To prevent plantar fasciitis, run on soft surfaces, keep mileage increases to less than 10 per cent per week, and wear the proper shoes for your foot type and gait. The running shoe that you wear is important. If you’re unsure if you’re in the right shoe, seek out advice from a professional.
Strengthening the muscles in your midfoot with barefoot exercises and experimenting with your running style by shortening your stride and quickening your cadence can also help.
Metzl says it’s also important to stretch the plantar fascia and Achilles tendon to loosen them up. While it’s typical to experience pain in just one foot, massage and stretch both feet. Do it first thing in the morning and three times during the day.
The following stretches can help you avoid injury:
- Achilles Tendon Stretch: Stand with the affected foot behind the healthy one. Point the toes of your back foot toward the heel of your front foot and lean into a wall. Bend your front knee and keep your back knee straight, heel firmly planted on the floor. Hold for 10 seconds. Repeat.
- Plantar Fascia Stretch: Sit down, and place the foot with heel pain across your knee. Using your hand on the side affected by plantar fasciitis, pull your toes back toward your shin until you feel a stretch in your arch. Run your thumb along your foot – you should feel tension. Hold for 10 seconds. Repeat.