RUNNING INJURIES SIMPLIFIED: Plantar Fasciitis

The stabbing pain! Oh!

If you’ve had Plantar Fasciitis, you know. If you haven’t, you’re lucky. It’s one of those running injuries that persists – but there is a way to try and keep it at bay.

WHAT IS THE PLANTAR FASCIA?

Plantar = ‘of or relating to the sole of the foot’

Fascia = ‘a band or sheath of connective tissue investing, supporting, or binding together internal organs or parts of the body’

In simple terms, the plantar fascia is a thick band that attaches to a ligament at the heel (plantar ligament) and splits off into three different sections attaching at the base of the toes. It plays an important role by stabilizing the arch, which keeps the foot upright through the gait cycle.

The plantar fascia bears quite a bit of tension during your run. As you toe off, your plantar fascia stretches a LOT – to get an idea of this, sit on the ground with your legs out straight and pull your big toe towards you. Can you feel how much your arch stretches when you do this?

Plantar fasciitis is a condition that develops when the tension placed on the plantar fascia becomes too great and the band of tissue begins to pull excessively on the plantar ligament attachment at the heel. The plantar ligament is usually strong enough to support the arch and elastic enough to bear the impact of the spring of your run. But if tension on the plantar fascia exceeds normal range of motion, micro tears build up, leading to this very painful and persistent condition.

HOW DO I KNOW IF I HAVE PLANTAR FASCIITIS?

The most apparent symptom of plantar fasciitis is pain at the base of the heel when you first step out of bed in the morning or get up after sitting for a while. The pain lessens as you loosen up a bit – most runners note that the pain isn’t really a factor during the run, but flares up again once they stop activity.

HOW DO I MAKE IT GO AWAY?

What do runners hate to hear? REST.

As with most injuries, rest is the first and most important step in treatment. If you can’t bear the thought of complete rest (because who can, really), at least work to reduce your mileage and switch to low- or no-impact activities for a period of time. Remember that test you just did where you pulled on your big toe? We need to reduce this – because remember that it’s all that tension that contributed to the injury in the first place. And when you run, the toe-off phase is what’s putting all that strain on the plantar fascia. How many times do you toe off during a run? Hundreds? Thousands?

STRETCH & MASSAGE. Grab a golf ball or stop by one of our stores and pick up a Trigger Point Nano Roller or Foot Rubz (available in all Marathon Sports stores) and do some light massage on the plantar fascia. Over time, this helps the fascia loosen up a bit, which means that the tension placed upon that ligament is less pronounced. Think of it as foam rolling for your foot! Make sure to stretch your calves as well – everything is connected.

If you’re really suffering, try out the Strassburg Sock – this is something that you wear at night, and it keeps your foot in a flexed position, which helps keep the plantar fascia from tightening up overnight.

HOW DO I PREVENT IT FROM HAPPENING?

Work to limit the factors that lead to plantar fasciitis in the first place. How does excessive tension get placed on the plantar fascia? Here are two contributing factors that you can work on:

BIOMECHANICAL IMBALANCE – we want your foot to be in the best position to absorb impact when you run. So if you have untreated overpronation (a collapsing of the arch during the gait cycle), there is extra tension placed on the plantar fascia that can lead to plantar fasciitis. Runners that have very high arches and supinate (underpronate) can also develop plantar fasciitis – its kind of like Goldilocks. Can’t be too low, can’t be too high, has to be just right.

MUSCLE WEAKNESS – specifically, the muscles of the foot. When we think of strength training for runners, we often think quads, hamstrings, core, calves…but the foot? Your foot has many small but important muscles that help the plantar fascia do its job of stabilizing the foot with every stride. Use a Thera Band to work on some foot stretching and strengthening – we like this one, from Competitor Magazine:

Information for this post was adapted from RUNNING STRONG by Dr. Jordan Metzl and INJURY-FREE RUNNING by Dr. Thomas Michaud