3 Points on Plantar Fasciitis for Runners
Runners put a lot of stress onto their feet. In fact the amount of impact placed on the foot is actually 3 times our body weight. Me being a foot specialist and an elite runner, I am here to share some education on running conditions and how footwear plays an impact on our foot health. I actually chose this field as I noticed in my sport most of my injuries were to the foot and lower limb. Makes sense if 3 times my body weight is hammering on my feet each stride! If you have a foot condition, please do seek professional for treatment as neglected pain can result in a more serious injury and more time away from running !
Three Tips on Plantar Fasciitis Include:
1. Plantar fasciitis Signs and Symptoms:
Plantar fasciitis is a painful condition that typically feels like a stiffness or sharp pain on the heel or arch of the foot. Signs of this condition is stiffness or pain with your first few steps in the morning out of bed. It can also be the first few steps after sitting for a prolonged period of time. I advise my patients that continuing to step down without stretching or working the tissues prior to stepping down, can cause more microtears to the fascia band. It is best to sleep with a GOOD night splint , stretch / roll out the foot before getting out of bed and immediately putting on supportive footwear prior to doing your morning tasks.
2. How This Injury May Happen :
Our body needs time to recover from stresses placed on the tissues. Without adequate attention to strengthening or stretching to help adapt to the repetitive strain placed on the tissue, erratic healing and injury can arise. This is a difficult injury to treat as the bottom of our feet don’t get much rest with the amount of time on our feet in our busy lives.
This condition is commonly found in those who walk a lot, run a lot, on their feet a lot or those who spend a lot of time in high heels. On a whole it is from lack of flexibility and lack of strength. It is proven that tightness is from weakness. Specifically in runners, the microtears from repetitive movements can actually weaken the lower compartment and lead to plantar fasciitis.
3. Treatment Options:
Rest is always best when injured. In most severe cases the goal is to first reduce the amount of pain for the patient. That may mean a prescription of anti inflammatory medications, aggressive taping, and support or an air cast to reduce foot impact. Pool running or spinning is a good way to stay fit while treating this injury. Shockwave therapy is a great modality, also offered at my clinic. There is some skepticism on its efficacy. Those who treat shockwave a band aid fix by just applying the treatment and send someone on their way, will have little hope for any benefit. The treatment is to be an adjunct approach with proper education and application of effective stretches, mobility, strengthening and footwear education. Soft tissue release and work of the lower leg compartment is also recommended. I tend to stay away from cortisone for runners, those who can take time off weight bearing activity and wear an air cast is only when I would recommend this approach.
In other cases an untreated plantar fascia injury can result in a stress reaction. That is why I always recommend long standing injuries of this nature that mimic bone conditions to be sent for an MRI from a licensed MD. Other options are Platelet Rich Plasma injections which uses the patient’s own platelets to accelerate healing. I do have a referral system set up at my clinic for those who may benefit from this.
Exercises and stretches are very important . As I explained earlier, stretching needs to be executed with the proper form so the stretch is felt. I typically like long stretches of both calf muscles , soleus and gastrocnemius to be held much longer than 30 seconds. Strengthening, I liked my patients to strengthen arches, intrinsics and lower calf muscles. This should all be done along any modality and after proper recovery time has been achieved after prp or cortisone procedures.
Footwear and orthotics are also key in treatment. In my experience footwear and support makes a big impact on foot conditions. Orthotics should be made to support the arch. I am not a big fan of lifts or anything that would exacerbate a tight calf. Only in the very early stages of the injury do I advise lifts, but my goal is to get the calf elongated and strong. I also advise people to wear a couple different heights of footwear from 4mm to 10 mm to help strengthen different angles of the ankle and calf when running. I am a big fan of firm soles opposed to soft flimsy footwear. For flatter feet, like myself, I am not a fan of light shoes for training. I am a big fan of support and the traditional school of stability footwear. Good brands make stability shoes light weight these days with similar Podiatric principles built into them. This includes medial flares, medial posts and even wider forefoot medial flares for forefoot support!
All in all plantar fasciitis is not one quick fix condition. It does require a holistic approach to treat the imbalances and restore function. I hope you will find some tips here if you are going through this painful condition and know help is available.