Do you have a Plantar Fasciitis Injury?

Plantar Fasciitis is a painful condition of the foot, in which the plantar fascia has become stretched or inflamed. It is one of the more common and bothersome of running injuries as the pain can last for months before the fascia finally heals. But don't despair! There are things you can do to speed healing and to prevent future occurrences. 

The plantar fascia is a thick, band of connective tissue that runs from the front of the heel to the ball of the foot. The plantar tendon keeps the arch of the foot from flattening completely when weight is placed on the foot. It is a natural shock absorption mechanism. However if the plantar fascia stretches too much, tears can develop resulting in painful scar tissue as it tries to heal.

Symptoms of Plantar Fasciitis

If you have plantar fasciitis, you are probably experiencing some of the following symptoms:

• Pain in your foot near the bottom of the heel or along the arch
• Pain is often worse when first standing in the morning or after sitting for long periods of time
• Pain may be worse when you first start to run and lessen as the tissue relaxes
• Pain may return after running or walking for extended periods of time
• Your arch may have dropped or become flat
  
  

Causes of Plantar Fasciitis

Too much stress on the plantar fascia causes it to overstretch and tear. Micro-tears are formed and the fascia begins to pull away from the bone causing inflammation. If the tendon is continuously over-stretched, calcium develops near the heel bone. Over time the calcium will develop into a heel spur creating more pain and discomfort in the heal. 

Research at the University of Delaware has concluded that there is a connection between high impact loading rates and plantar fasciitis. Other studies have shown a connection with dorsiflecting (landing on the heel with the foot pointing up) and the development of this condition. These findings are a strong indication that heel striking is a major factor in the development of an inflamed plantar tendon. If you land on your heel while running and you often have pain in your heel area, changing to a forefoot or mid-foot strike could greatly improve the health of your feet.

Other factors that may be contributing to this condition are: 

• Over-striding, which encourages heel striking
• Slow cadence (turnover rate) while running
  
• Weak or tight muscles in the foot
• Tight calf muscles 
• An inflexible Achilles Tendon
  
• Transitioning too quickly to minimalist shoes
  
• Walking barefoot in the sand for too long when your feet are not used to it
  
  

Treatments and Prevention

If you suspect you have Plantar Fasciitis, you should stop running or reduce the amount of training depending on the severity of your condition. Common sense rules!

Check your running posture to ensure that you are not over-striding. Your foot needs to land directly below your center of gravity using a forefoot or mid-foot strike. A proper running foot strike will help to stretch and strengthen the ankles and calf muscles.

Increase your cadence to 180 steps per minute (90 for each foot). Cadence is the number of times your feet hit the ground each minute while running. Having a quick cadence helps to ensure that you are not over-striding and your feet are not on the ground any longer than they need to be. 

Make sure that your lower legs are relaxed. Any tension in your calves or lower muscles will pull on your plantar tendon and cause more irritation.  

Try icing the area to help reduce the inflammation and increase blood flow to the area, which helps to speed recovery.

Wearing a Strassburg Sock or Night Splint while you sleep will keep the plantar fascia from constricting and becoming tight overnight.

Try self-massaging the plantar fascia to help it relax and try taping the arch as it can be helpful in reducing the pain.

Try Reiki for Runners to help restore and balance the body's energy, decrease pain levels and speed healing.

Use one or more recovery products to support your foot while it is healing to speed healing and reduce pain. The following is a selection of what's available:

Do stretching exercises for your calves and feet. The following exercises may help:

• Use a golf ball to stimulate and stretch your arch. Place the golf ball on the floor and roll your foot back and forth over the ball. You will feel the plantar fascia stretching.
• Try picking up objects with your toes: socks, marbles, etc.
• Do toe pulls - grab a towel with your toes and pull it towards you
• Foot stretch - sit with one foot on your opposite knee. Grab your toes and front part of your foot with the palm of your hand. Pull the foot toward you in a manner in which you can feel the foot stretching.
• Achilles tendon and calf muscle stretch - keep one foot flat on a stair step. Place the arch of your other foot on the edge of a step. Then let your heel drop slowly to get a good stretch. Alternate feet positions to give both your calves a good stretch. This stretch can also be performed on a street curb. 
• Orthotics may be used as a short term solution to help with the pain but a long term solution involving correcting the initial cause of the problem would be more beneficial.

In more extreme cases, a physician may recommend a cortisone injection to quickly reduce the inflammation. However, this should only be used in severe cases as there are possible side affects when using injections in the heel area.

As with all injuries, it is best to try to prevent them before they occur.  Correct any deficiencies in your running posture and ensure your body's movements are relaxed and flowing without any constrictions.

When you are no longer feeling pain in your foot, you may want to try to take some preventive action by making your feet stronger. Walk barefoot (with or without socks) as much as possible to help stretch and strengthen the plantar tendon. At some point you may want to consider transitioning to minimalist or barefoot running shoes. This style of running encourages a mid-foot strike and the flexible shoes allow the feet to stretch out and strengthen. A word of caution though: switching to minimalist shoes should be done gradually and properly. Read more about transitioning to Barefoot Running to ensure you approach it sensibly. 

Other related articles:

Natural Running Form

Barefoot Running Form

Barefoot Running Shoes

Reiki for Runners

One Runner's Experience with Plantar Fasciitis

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