Plantar Fasciitis can be a stubborn injury that causes intense heel pain for runners. It can lead to extended time off running and even disrupt normal life activities. Let’s review what you can to do prevent it and recover.
As a runner, you’re at a greater risk of suffering from plantar fasciitis than the average person. And so, I highly recommend all my runners learn more about this injury even if they’re not currently suffering from it.
There are things you can do to prevent it, and in case you’re dealing with it right now, you’re not alone.
We recently chatted with Dr. Lisa Mitro, DPT, on the podcast to break down everything you need to know about plantar fasciitis, what causes it, how to manage it, and how to keep it from coming back.
What is Plantar Fasciitis?
Plantar Fasciitis is essentially an inflammation of the plantar fascia, which is a fibrous band of tissue along the sole of the foot that connects the heel bone to the toes.
It can cause intense heel pain and is one of the most common causes of heel/foot pain as well. Plantar fasciitis can manifest as stabbing pain that is usually be felt with your first steps in the morning.
The pain normally subsides after getting up and moving, but it may return after long periods of standing or standing up after sitting for a while.
It’s a problem many runners face, in fact you’re more likely to suffer from plantar fasciitis if you’re a long-distance runner. This is due to the repetitive stress we place on that ligament.
To try and understand this injury a bit more, let’s take a look at its symptoms.
Symptoms of Plantar Fasciitis
Not sure if your pain is Plantar Fasciitis?
Here are some common signs and symptoms:
- Sharp stabbing or aching pain in the heel
- Pain is usually worst first thing in the morning with sharp stabbing or burning pain.
- Pain often returns later in the day after being on your feet all day.
- Arch pain or tight calf muscles
- Pain doesn’t spread beyond the plantar fascia area of the heel and possibly the arch.
As a reminder, there are other potential causes of heel pain after running, so if this doesn’t seem to quite fit, check those out.
Can You Run with Plantar Fasciitis?
When we asked Dr. Lisa about running with plantar fasciitis, her answer was reassuring: “Yes, in many cases you can keep running. It’s just a matter of making modifications when necessary and not pushing through the pain.”
This is where load management comes in. Rather than stopping completely, we adjust your training load to reduce stress on your foot.
The first step is to pull back on anything fast or intense. Remove speedwork, then, if needed, pull back on mileage and add more recovery between runs.
Pay attention to your pain and start to keep notes:
- How does your foot feel during your run?
- How does it feel later that day?
- How does it feel the next morning?
Light, manageable discomfort that doesn’t change how you run or walk is usually okay. But if the pain ramps up, sticks around, or starts to alter your gait, that’s your cue to switch to walk-run intervals or take a short break to let things settle.
If you catch plantar fasciitis early and adjust your training, you don’t have to fully stop running. You can keep building strength and stability while letting the tissue calm down.
Most importantly, I want you to know that it IS A PROBLEM to take pain relievers before running. It can cause a host of issues, so you need to find the cause of your pain.
Causes of Plantar Fasciitis
Plantar fasciitis at it’s core is an overuse injury, meaning the fascia is taking on more load than it’s currently prepared to handle.
This happens when the foot isn’t moving as efficiently as it could, especially if the big toe and arch aren’t doign their job to stabilize during walking and running.
If the big toe isn’t pressing into the ground well, the arch can collapse or shift, which places extra stress where the plantar fascia attaches at the heel.
Plantar fasciitis in runners is usually caused by:
- A sharp increase in mileage
- Big increase in speedwork
- Weak feet or arches
- Runners with flat feet
- Improper shoes for your strike and foot (pronation)
- Tight calf muscles (lack of stretching)
- Tight Achilles tendon
- Weak big toe
Risks of Ignoring Plantar Fasciitis
When plantar fasciitis is brushed aside and we just keep pushing, it has a way of hanging around much longer than we’d like.
The body is smart; if something hurts, it will find a different way to move so that you can keep going. The catch is that those little “workarounds” over time can lead to:
- increased stress elsewhere in the foot
- bunions due to shifting load toward the inner forefoot
- ankle issues or sprains if you are rolling weight to the outside of the foot to avoid the discomfort
- changes at the knee or hip because your stride really influences the entire chain
If you pay attention early and make a few small training or strength adjustments now, you can save yourself months of frustration later.
Think of it as giving your foot a chance to catch up so you can keep doing what you love, without the nagging heel pain tagging along.
How to Get Diagnosed
If you suspect you have plantar fasciitis, I recommend heading to your doctor. You need to know what this is to start appropriately treating it right away.
Physical therapists are trained to tease out injuries of the plantar fascia itself from those mimicking it, such as flexor hallucis tendinitis, interdigital neuroma, and injuries to the joints of the foot. So expect them to put you through a few movements to land on the correct diagnosis.
You may be asked to flex your foot while they push on the plantar fascia to check if the pain gets worse as you flex and better as you point your toes.
Imaging tests, such as an X-ray or MRI, may also be used to correctly diagnose plantar fasciitis. Although you can really get a good look at soft tissues with an X-ray, it can be helpful when trying to rule out other possible causes of heel pain, such as bone fractures and heel spurs.
Big Toe Strength
It may not be the first place your mind goes when your heel hurts, but the big toe plays a huge role in how your foot supports you when you walk and run.
Think of it like the thumb of your foot, when it can press into the ground and do its job, the arch lifts and stabilizes, and the plantar fascia doesn’t have to work nearly as hard.
When the big toe isn’t engaging well, the arch may collapse or roll in to make up for it, which sends more stress straight to your heel. Over time, it’s often one of the sneaky reasons plantar fasciitis shows up or sticks around longer than it should.
Don’t worry, we’re not about to hand you a whole new list of exercises. You’re likely already doing things like single-leg deadlifts, step-ups, and balance work. The key is how you do them.
Next time you’re doing these movements, focus on driving your big toe into the floor. Seriously, that’s it. You could even focus on driving your big toe into the floor as you’re standing at your desk, at the kitchen sink doing dishes, or sitting there watching TV.
Or use tools like the Mobo Board, which forces you to balance while driving your big toe into the ground, or in this case, the wooden circle.
It’s a small cue, but a powerful one, and it can make your foot feel much more supported with each step.
Want to learn more about the importance of big toe strength? Listen to the full episode on the Tread Lightly Running podcast.
Stages of Recovery for Plantar Fasciitis
Before you read on, it’s good to know that recovering from an injury moves in stages: acute, rehab and then prevention.
And, it’s also good to know these stages don’t always move in a forward direction. Expect a circuitous course with ANY injury. Our bodies are not easily “fixed”.
So how long does plantar fasciitis take to go away…it can take a very long time.
But don’t get frustrated, just keep following these tips!
{Amanda’s note: boy do I feel this!! Recovery from knee surgery was slow, then speedy, then a little setback, then on the road again. Do your best to take it one day at a time and know that it CAN and WILL get better if you persist with finding the right info for your body.}
So, which stage are you in?
ACUTE – your injury is recent and it’s quite painful, it’s difficult to walk and/or run
REHAB – your pain is intermittent and moderate to mild, you’re feeling able to get back to exercise
PREVENTION – you’re running pain free and loving life. In this stage, you’ll do some routine maintenance to keep it that way.
Acute Stage: Begin Recovery Process
In the ACUTE STAGE, you’re going to be begging for exercises, but your injury needs active movement, compression, protection and ice before you can begin to rehab it.
Can I say that again for the folks in the back? Many ask for exercises and stretches at this stage, but ankle/foot stretches and strengthening exercises need to wait a bit.
Ice
Your number one goal when pain is high and you’re having trouble walking is to get that pain under control. Ice the bottom of your foot with a frozen water bottle or dunk it in ice water for up to 15 minutes then let it come back to a normal temperature. Repeat as needed.
This is also the time to start doing all those anti-inflammatory things Amanda preaches! 
Compression
Use a compression sock for comfort and to decrease excessive swelling. Compression socks are designed to reduce inflammation and these particular socks help to provide additional ankle and arch support.
Feetures Plantar Fasciitis socks are HIGHLY recommended by runners dealing with this issue. As I tested them out, I could see why. They are providing that compression feel along side what feels like some arch support.
100% worth adding them to the rotation as you try to find a solution.
Sensible Shoes
Wear what your Grandma would call “sensible shoes” – sneakers, hiking boots, cushioned slippers – something that allows you to walk pain free, even when just walking around your home.
At night, keep a pair of slippers or flip flops at your bedside for bathroom and snack trips. Most running stores carry “recovery flip flops” that can also be used around the house. In essence, you want SUPPORT.
Taping for Plantar Fasciitis
Amanda is a massive fan of RockTape as it made running with her knee injury possible, so we know it’s a great option.
But as will all things, careful not to overdo it just because it makes things seem like they’re better. 
There are a lot of techniques for taping to relieve foot pain, you’ll have to experiment to see which one works for you. Read more on the example above.
Fight the Urge to Stretch!
Most stretch too aggressively and this can make the injury worse.
Initial plantar fasciitis recovery plan:
- Make slow circles or letters with your foot throughout the day.
- Move your toes up and down as far as you can.
- Use your fingers to stretch your toes apart or consider purchasing a toe spreader, carried at most pharmacies.
- Bridges and clam shells for strengthening are ok
Stay in the pain free zone with everything.
Find a type of cardio exercise that’s pain free – cycling or swimming are usually tolerated well – to maintain your fitness.
Rehab Stage: Evaluate
In the REHAB STAGE, slowly move into different shoes. Meaning you can start to leave behind the sensible…but really should consider upgrading or changing our your shoes to ensure they aren’t part of the issue.
Let’s go through some ideas for shoes and exercises that you can start to utilize immediately.
Lever Running
When elite athletes return to workouts after an injury, Plantar Fasciitis or otherwise, they often utilize tools that reduce their body weight. In the past this meant an AlterG which is insanely expensive and only available in Dr’s office, but now we have Lever Movement system for at home.
I use this and a large number of athletes from the everyday to elite have started using it at home as well. Specifically for Plantar Fasciitis this is going to reduce the weightload on the foot, which means the muscles won’t be spreading out so much with each step.
By reducing this amount, you can ease your body back in to running with less chance of inflamming the Plantar Fascia.
Too many runners try to jump back in to normal training and quickly end up in pain again. Whether you feel in a hurry because you have a race or simply can’t wait to get going, this is a smart way to get started.
Checkout the full Lever Movement System >>
Lever Movement Discount Code: Runtothefinish for 20% off
Good news, you’ll continue to get usage out of this even after injury. It’s great for increasing mileage or even getting in a few more speedy miles to help the legs feel the turnover without a big jump in HR.
- If you’ve been off running for more than a month, you might choose to start with all Lever runs. Take off the maximum amount of weight and then each week take off less weight.
- If you’re just trying to avoid a full blown injury you might try substituting Lever for a couple of runs each week. Play with the weightload to find what gives you the most relief while still being a good workout.
Plantar Fasciitis Exercises for Re-Hab
- Begin stretching toes against a wall
- Use a tennis ball or a can to massage the bottom of your foot
- Use Alleviate Arch massager target specific areas that a tennis ball or water bottle can’t
- Begin single leg balance (stand on single leg while holding the other at 90 degrees, advance to standing on a pillow)
- Use a Strassburg sock or boot for gentle Achilles stretching. Pro tip: these devices are better tolerated during the day while at work or while watching TV than when sleeping.
- Start towel curls and isolated movement of the toes
If you can’t move your big toe up and down independent of the little toes, keep trying!
It’s like figuring out how to ride a bike. One day your brain will “get it”, your muscles will learn to do these movements and become stronger, protecting your foot from re-injury.
Once your foot is pain free, ease back into walking for exercise and then running. Note this didn’t stay start running right away, it said fix the issue then walk…then run.
What are the Best Running Shoes for Plantar Fasciitis?
Pain from plantar fasciitis can make it difficult to play sports, run, or even stand for long periods of time. Picking the proper shoes for your feet is essential if you have plantar fasciitis pain. You will notice that many of these are stability shoes, which means they’ll have more arch support.
If you’re not sure which shoes are going to give you the best cushioning and support, check out some of our top picks. We’ve put together a list of the best running (and walking) shoes for plantar fasciitis, based on recommendations from PTs, feedback from our gear testers, and even some personal experience.
Prevention Stage: Keep it From Coming Back!
In the PREVENTION STAGE,we’re committing to ongoing treatment protocols to prevent that pain from reappearing.
- do the toe spreading and toe movements two or more times each week
- continue the glut exercises too, to strengthen hips and glutes
- Work toward being barefoot in the house and then in your yard to develop balance and strength of the smallest muscles of your foot
If anything flares up, head right back to the acute stage strategies until it’s under control. Heel pain when running is NOT normal, don’t convince yourself that it is.
Does your pain persist after trying all of this? Book a PT consult.
They can assess your posture, movement patterns, test for muscle imbalances, protect the foot with taping and even use dry needling to bring things into balance.
Like we mentioned above, plantar fasciitis pain isn’t something to just ignore. While you can still keep running, it’s important that you make the modifications to strengthen your foot muscles, especially your big toe!
We hope that this information about plantar fasciitis was helpful and gives you a place to start.
Looking for more tips?
- Common causes of running foot pain
- Should you get a cortisone shot? (A must read for PF)
- How does Kinesio taping work
Other ways to connect with Amanda
Instagram Daily Fun: RunToTheFinish
Facebook Community Chatter: RunToTheFinish
Get more running tips: Pinterest
The post Dr. Lisa Mitro: Why Most Runners Treat Plantar Fasciitis Wrong (And What Works) appeared first on RunToTheFinish.
from RunToTheFinish https://ift.tt/tJ532yQ
Post a Comment
Post a Comment