Plantar Fasciitis (PF) is no joke. One in 10 runners will suffer from plantar fasciitis at some point during their running life and, if not treated, the condition may become long-lasting and chronic. No Bueno. So, what is Plantar Fasciitis, why do some runners get it, and how do we effectively treat it?
According to Wesley Miller, PT, FAAOMPT, who works with runners in Asheville, NC, “There are two groups of people that are more likely than others to have plantar fascia issues. One is those with high, stiff arches that don’t move sufficiently enough to allow for easy shock absorption and, two, are those with arches that fall from a medium to flatter position (navicular drop) during motion.”
Like your IT band, and patellofemoral complex, Miller, says the plantar fascia are passive shock absorbers. This means that when ground reaction forces get higher than your muscles can tolerate (like during running) the plantar fascia takes on more load. So, he says, in general, “the more mileage you do, the more susceptible you are to foot issues.”
Research indicates that PF is a result of the plantar fascia—which connects to the heel on the bottom of the foot—moving away from the insertion point at the heel. Dave Strassburg, of Strassburg Medical (the company that makes the Strassburg sock, a PF treatment), describes it like this:
“Think about if you had a cut on your knuckle. While your finger is straight, the cut can close up and heal,” he says. “But, the moment you bend your finger, the cut bursts open again.” This is similar to how PF works and why it tends to be most painful in the morning. While you’re asleep at night, the fascia starts to heal and reattach. Then, when you wake up and bear weight on your foot, bam, you’ve torn it open again.
So, short of never standing up again, how can you effectively treat PF? Well as expected, research varies. Herewith four ways to effectively treat your PF now.
Note: Please consult with your doctor or physical therapist before trying any of the exercises below.
Running is a repetitive action and wearing the same shoes every day adds additional repetitive stress to your feet whether you have high, rigid arches or flat feet. Rotating through a few pairs of shoes during the week will help to keep your feet strong. Consider using one pair for long run days, one pair for speed workouts, and another pair for easy days.
Before you buy your shoes, though, make sure you get the right size and model for your foot and your specific training. Additionally, wearing proper insoles may add additional comfort and support throughout the healing process. A Fit Specialist can easily help you with this (check in with your local store for assistance).
While treatment options for PF are wide-ranging, both a 2008 study and 2012 survey that queried foot and ankle specialists, found that slightly over half of all surgeons preferred stretching and physical therapy as PF treatment over any other mode of therapy. And, statistically, stretching seems to yield the best results.
Here are three stretches to do first thing in the morning and before bed at night:
A study published in the Scandinavian Journal of Medicine and Science and Medicine found that high-load strength training “may aid in a quicker reduction in pain and improvement in function” associated with PF. In fact, after just three months, patients who had incorporated the prescribed strength training—unilateral calf raises with a towel under their toes—experienced more improvement than the control group (those that simply stretched).
To try it, use a stair step or a block. Roll a towel and place it under your toes (the thickness of the roll will vary based on your foot but should allow for maximum dorsiflex at the top of the heel rise).
Starting from the bottom, rise slowly for three seconds. Pause at the top for two seconds before slowly lowering back down. Perform three sets of 12 with a minute rest between each.
While participants in the study wore a weighted backpack, consider using your body weight until you feel strong enough to add weight.