Plantar Fasciitis
Plantar fasciitis is the most common cause of heel pain and third most common injury amongst runners (3). Fortunately this common injury can often be treated without surgery. Check out the information below to learn how to overcome plantar fasciitis and get back to doing the things you love!
Plantar Fascia
The plantar fascia is a band of thick tissue that runs along the plantar (bottom) side of the foot. It originates at the calcaneus (heel bone), spans the bottom of the foot, and connects at each of the toes. The plantar fascia is an important structure for supporting the inside arch of the foot, and is under a massive amount of tension (forces that try to stretch out the tissue) during weight-bearing activities such as walking and running.
Symptoms of Plantar Fasciitis
Plantar fasciitis is the most common cause of heel pain. Pain is usually isolated to the heel and is worse after a long period of rest (such as when getting out of the bed in the morning) and while weight-bearing. It classically causes “start-up” pain, because the pain is worse in the mornings or after a long period of sitting (the plantar fascia gets tight while sleeping). Generally, the pain gets better throughout the day, then recurs before bed. The pain is worse while walking barefoot, but improves while wearing athletic shoes that support the arch.
Common Causes of Plantar Fasciitis
Plantar fasciitis occurs when the plantar fascia becomes irritated and inflamed. As we noted above, the plantar fascia experiences massive tensile forces when we are on our feet. When these forces are too large or repetitive the tissue can become injured. Running is an activity which commonly leads to this injury. Additional factors which can overload the fascia and increase the risk for developing plantar fasciitis include limited ankle range of motion (mainly, ankle dorsiflexion, which is the ability to flex your ankle and bring your foot up towards your shin bone = “opposite of gas pedal movement”) and excessive pronation (the inward rolling of your foot when it comes into contact with the ground), being overweight, and standing at work all day (2).
Treatment & Prevention of Plantar Fasciitis
There are a number of conservative treatments available for plantar fasciitis, including physical therapy, plantar-fascia-stretching exercises, icing, night splints, inserts and orthotics, and non-steroidal anti-inflammatory drugs (NSAIDs)(1). The most effective non-operative treatments are night splints, which keep the plantar fascia stretched out overnight, and calf stretching exercises, which improve ankle dorsiflexion.
Unfortunately, plantar fasciitis tends to linger for many months despite these treatments. It’s not uncommon for plantar fasciitis to last 6-9 months and finally improve with rest, calf stretching, and night splints! In cases that do not respond to conservative treatment, platelet-rich plasma (PRP) injections may be employed (1). Generally, local steroid injections are not indicated because there is some data to suggest that this can lead to rupture of the plantar fascia. In the most unresponsive chronic cases surgery may be considered, but again almost everyone gets better without surgery!
Now get out there and live a Strong, Healthy, and Happy life!
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REFERENCES
- Martinelli, N., Marinozzi, A., Carnì, S., Trovato, U., Bianchi, A. and Denaro, V., 2013. Platelet-rich plasma injections for chronic plantar fasciitis. International orthopaedics, 37(5), pp.839-842.
- Riddle, D.L., Pulisic, M., Pidcoe, P. and Johnson, R.E., 2003. Risk factors for plantar fasciitis: a matched case-control study. J Bone Joint Surg Am, 85(5), pp.872-877.
- Taunton, J.E., Ryan, M.B., Clement, D.B., McKenzie, D.C., Lloyd-Smith, D.R. and Zumbo, B.D., 2002. A retrospective case-control analysis of 2002 running injuries. British journal of sports medicine, 36(2), pp.95-101.
In Part 6 of this series of articles, Cathy describes her daily core strength and flexibility routine to stay strong and mobile.