Injury

Plantar Fasciitis
October, 2010

Its 5:30 a.m., your alarm goes off, you jump out of bed eager for your morning run, but as soon as you take a step, bam! A sharp pain is felt on the bottom of your foot. You can barley walk, but like most endurance athletes you ignore it and run anyway. As the run progresses your foot surprisingly feels better! As the day progresses the pain gradually comes back and the same pain occurs the next morning. Unfortunately, it looks like a case of plantar fasciitis.

Plantar fasciitis is the inflammation of the plantar fascia or the tissue that sits between the first few layers of the intrinsic muscles (muscles that are only found in the foot). The plantar fascia is not a tendon or a ligament. It is a band of thick fibrous tissue that runs from the bottom of your heel to the bottom of your fore foot. Its function is to help support the arch, more specifically the longitudinal arch (the arch that we try to support with proper footwear and orthodics). The function of fascia tissue is to separate and support your muscles. What should you take from all this? The key word when describing the function of the plantar fascia is support. Now that we know what plantar fasciitis is, let’ s go over how to recognize and avoid it.

Foot pronation (rolling in)

• Tight achilles tendon, gastrocnemius, or soleus muscles (calf muscles)
• Weight gain
• Falling arches
• Poor running shoes
• Faulty biomechanics
• Increasing of mileage too quickly (overuse)

Signs and Symptoms

• Athlete’ s pain is generally in the middle of the calcaneous (heel) and also moves down the foot
• Pain with weight bearing activity after sitting for a long period of time
• Pain diminishes with activity
• Pain is increased when toes are pulled towards the shins

Treatment

• Proper footwear
• Orthodic or foot bed if necessary
• Stretching the gastrocnemius, soleus, and plantar fascia
• Massaging the plantar fascia
• Ice massage the bottom of the foot
• Decrease running mileage
• Over night splint that stretches the foot

Jason’s Recipe to get rid of plantar fasciitis

• First and foremost be fit with a proper pair of running shoes and arch support (if necessary) for your biomechanics. When doing so, it is important to make sure that the feet are not the only things being evaluated. Research has shown that plantar fascia can also be caused by faulty biomechanics. What does this mean? Your body is a kinetic chain, meaning that if one portion of your body is misaligned, another portion can be affected. For example, if you have a semi-high arch and you are having plantar fascia problems, an orthodic or foot bed, in addition to your shoe may not be the answer. The problem could be stemming from your tight hips altering the way your foot strikes the ground.
• Every morning before you get out of bed, massage the bottom of your foot very lightly. Next, stretch the bottom of your foot lightly. This can be done with a towel or a partner. Then put your running shoes on before you take your first step out of bed. This will prevent your arch from collapsing all the way, creating less of a dynamic (forceful) stretch on the affected area. Walk around for a few minutes so the blood gets flowing and warms up the bottom of your feet.
• Throughout the day stretch the foot and calf muscles very lightly.
• If you decide to go for a run, warm that foot up with a little bit of massage or by rolling a golf ball or tennis ball underneath the foot.
• Stretch lightly again.
• If at any time during the run you feel pain over a 5 on a scale from 1-10, stop.
• When you get back from the run stretch your foot and calf muscles.
• Following the stretching, ice the bottom of your foot with an ice massage. You can do this by filling up a small dixie cup with water and freezing it. When it is frozen rub the ice on the bottom of your foot.
• Repeat this every day!

I realize this is a lot of information to retain so feel free to email me at any time with more specific questions whether it is how to perform a stretch or for further explanation of biomechanics.

Jason is a USAT Level 1 certified coach as well as NSCA-CPT (National Strength and Conditioning Association-Certified Personal Trainer). He holds a degree in Health and Exercise Science from Rowan University. Jason competed at the collegiate level in cross country and track. He has been a personal trainer for five years and a running coach for three. Among the talented athletes he has coached are those who qualified for the Boston marathon, NJ high school meet of champions, and several athletes who have completed their first triathlon. Jason feels his education and triathlon experience will help him in becoming a successful coach for many years to come.

- Coach Jason Kilderry