Plantar Fasciitis: Prevention is the Best Medicine

by Teige West

Plantar Fasciitis (plan-tar fash-ee-i-tis) is a common foot injury for athletes who participate in running sports. The injury can be very painful, and very frustrating because the pain can become chronic if not properly addressed. In this article, we’ll discuss the causes, the symptoms and ways to prevent and treat plantar fasciitis.

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The Requisite Anatomy Lesson

The plantar fascia is a band of tissue that runs from your heel almost to your toes, covering the entire bottom of your foot. See below[1]:

When this ligament becomes inflamed, you have plantar fasciitis (the –itis always indicates inflammation in a body part). The symptoms are: swelling, limping, tenderness; and pain in the heel, the ball of the foot or the entire sole. The pain may be worse in the morning, recede during the day and then return after exercise. Often PF can be confused with a heel spur or Achilles tendonitis because the sufferer may experience pain toward the back of the foot. If you experience any of these symptoms, stop exercising, and rest until you can see a doctor who can properly diagnose your discomfort.

What are the causes of PF?

1. Running. Athletes who run have a higher incidence of injury than nonrunners because of the high impact when your foot hits the ground. Poor foot mechanics, such as flat feet, high arches, or other abnormalities may increase your risk. You know as a hurdler than proper form is everything, so one way to prevent PF is to practice good form and wear proper shoes while training.
2. Overuse. You have a heavy training schedule, and the drills and cardio all require foot movement, which means you’re constantly working that ligament. Observing your rest days will reduce your chance of injury (and not just this injury—all of them!). Give your muscles and tissues time to repair and rebuild, so even when you feel pressed to skip your rest day—don’t. When you increase your training schedule, do so incrementally. If there are three new drills you need to practice, don’t add all of those on one day. Add one this week, the second next week, and after two weeks, add the third. You may even need to increase training less frequently, depending on your fitness level. Wear proper shoe support at all times, even when lifting.
3. Standing for long periods of time. If you have a job that requires being on your feet, such as retail workers, soldiers, cashiers, nurses, etc. you are at risk for plantar fasciitis. Rest on your breaks—be sure to sit down; stretch your feet (see below). Wear proper shoes or insoles.
4. Weight gain. This is probably not a factor for you because you’re active, but if you are on the thin side and want to bulk up, be aware that PF does occur with more frequency when people add body weight. You should be strength training and eating according to a diet that allows for gradual weight gain, if you are planning properly. If you have foot problems, talk with your dietician or trainer to make sure PF and other foot issues won’t be a concern as you take on muscle weight.

Plantar Fasciitis Prevention

In addition to the advice above, there are some stretches you can do to prevent this injury. Often, tight calves and ankles can contribute to PF, so keeping the lower part of the leg loose and limber can aid in prevention. You should already be stretching these areas before and after training and competition, but some people are more prone to tightness in the lower part of the leg. If that’s you, or if you’ve recently added new drills, strength training, etc., and now you’re started having issues with leg tightness, try these techniques below. (Additionally, remember to use heat and a hot bath to relax muscles and tissue)

Calf Stretch: You should already use this stretch, or some form of it. Place feet one in front of the other, about a step apart, facing a wall. Press your hands against the wall, lean forward and stretch the back of your calf by pressing your heel into the ground. Hold for 20- 30 seconds. Repeat on each side 3x.

Step Stretch: Stand with your toes on the edge of a step. Lower your heels gently until you feel a good stretch in your calf, hold for 5- 10 seconds. Repeat with the other foot. Repeat 3x.

Foam roller or frozen water bottle: Place a foam roller underneath your foot and gently roll back and forth for 3 minutes. Repeat with both feet. You can also foam roll or use a plastic roller on your calves. If you don’t have a roller, you can freeze a water bottle and use that instead.

Use a towel: Sit on a bench or chair. Loop a towel around your sole, leg extended, and hold the ends in each hand. Press your foot against the towel and pull the ends toward you. Repeat with each foot.

Toe pull: Sit in a chair. Cross your ankle over your opposite knee and grasp your big toe. Gently pull it toward you, moving the toe around gently. Now push the toe down toward the ball of the foot gently. Repeat 5x each side.

An easy stretch for the mornings: Before you get up in the morning, roll onto your back. Gently pull your toes toward you, stretching out your feet and calves. Repeat 5- 10 times. (This stretch is also great for tendon issues because your tissue contract while you sleep; think of this as a warm-up for getting out of bed.) You can also do this while relaxing or from a sitting position at your desk.

Treatment of Plantar Fasciitis

Hopefully, you won’t ever have this injury, but if you do, the immediate treatment is the same for any inflammatory injury: RICE. Stop training immediately and rest. See a doctor to rule out other potential injuries. Use ice for the swelling phase, alternating 20 minutes of ice 3-4 times a day. Your doctor may recommend a wrap or special sock. Remember to elevate your foot until swelling subsides.

Because PF has no proven course of treatment for every sufferer, your doctor may try various treatments before one significantly reduces your symptoms, such as a night splint, a walking boot, or special insoles. You may have to try several of these simultaneously, or over the course of your treatment. Unfortunately, PF can take weeks or months to heal, and can be a reoccurring problem. While recovering, you can do low impact exercise, such as swimming, biking and some strength training that can be tolerated with your injury. The best combination for prevention is to plan rest days, stretch, avoid overuse by incrementally increasing your training, and always wear proper shoes, even if they aren’t as fashionable as you’d prefer.

[1] Photo: https://orthoinfo.aaos.org/en/diseases–conditions/plantar-fasciitis-and-bone-spurs

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