What is Plantar Fasciitis?
It’s probably not surprising that around 15% of all running injuries strike the foot. When running each step you take leads to your feet absorbing a force several times your bodyweight. While the foot is in motion during running, the plantar fascia, a thick elastic tissue that stretches from the heel to the base of the toes, works with the Achilles tendon to store and return energy.
Because of this powerful attachment, the plantar fascia stabilises the inner forefoot as forces peak during push-off at the end of a stride. Unlike bone spurs and stress fractures of the heel, plantar fasciitis tends to cause pain when you are pushing off while running, and not during initial contact when the foot lands on the ground.
Recent research has shown it to be similar to a tendinopathy, where there is a degenerative process involved, including features of collagen breakdown, calcification, nerve and vascular ingrowth. This is why it can sometimes be referred to as plantar fasciopathy.
What are The Symptoms of Plantar Fasciitis:
There are a number of common symptoms that will tell you you may be suffering from plantar fasciitis. If you find yourself suffering from any of the symptoms listed below our advice would be to contact a physiotherapist to discuss the best way to treat the problem.
- A sharp stabbing pain or deep ache in the arch of your foot or in the middle of the bottom of your heel.
- Stiffness or pain first thing in the morning (especially when you first get out of bed) that becomes slightly easier after a few steps but then tends to worsen during the day when your body fatigues.
- Pain that gets worse when climbing stairs or standing on your toes.
- This is a nagging injury and although it is possible to carry on running through it, doing so will probably result in the healing process being delayed. If you continue running with Plantar Fasciitis, quite often when you have warmed up the pain eases but then returns towards the end of your run or later that day. Be aware this can become a vicious cycle.
If the problem persists it is important to seek the help of a medical professional to find out the best way to alleviate the problem. The team here at Physio Action are well versed in the treatment of Plantar Fasciitis so if you are experiencing problems call our team immediately.
What Causes Plantar Fasciitis:
Plantar fasciitis may result from a variety of factors, such as overtraining, doing vigorous repeated hill workouts or speed work, neglecting to stretch tight calf muscles, wearing unsupportive shoes, starting a running programme too aggressively or a general lack of foot strength. It can also be attributed to biomechanical factors such as fallen arches. The excessive lowering of the arch in flat-footed runners increases tension in the plantar fascia and overloads the attachment of the plantar fascia to the heel bone, leading to eventual inflammation.
Other biomechanical factors include an inward twisting or rolling of the foot (pronation) and tight tendons at the back of the heel (Achilles tendon), with reduced ankle dorsiflexion (upward movement of the ankle) and poor foot flexion and eversion (twisting ankle outwards) strength.
What Can You Do to Treat Plantar Fasciitis:
Plantar fasciitis is considered to be a self limiting condition with no definite timescale. The length of time people suffer from plantar fasciitis will vary. Generally with regular treatment symptoms will improve in 3-6 months. However, if your daily regime involves prolonged standing and painful loading of the tissue recovery could take longer maybe 9-12 months. There are a number of fixes when it comes to plantar fasciitis which include:
- Lightly stretching and mobilising the fascia throughout the day by, rolling your foot over a golf ball or over a frozen water bottle. Manually stretching your foot by pulling your toes back is particularly useful first thing in the morning.
- Wear supportive footwear with enough shock-absorbing cushioning through the day and avoid prolonged standing, especially on hard surfaces.
- Physical therapy to mobilise and release tightened fascia on the foot, as well as the ankle joint, calf and Achilles tendon.
- Massage therapy to release the tight structures of the lower limb and foot.
- Night splints (including the Strassburg Sock), which holds the foot with the toes pointed up and the ankle at a 90-degree angle, can reduce morning symptoms.
- Performing prescribed stretching and strengthening exercise for the foot and the hip/pelvis and your core.
- Cross train with water running, swimming, elliptical and cycling.
- In the most severe cases surgery could possibly be required to release the fascia, however, this is normally only required in less than 5% of cases.
What Steps Can You Take to Help Prevent Plantar Fasciitis:
There are a number of things you can do to help minimise the chances of plantar fasciitis. For a start try running on a variety of surfaces, especially softer surfaces such as dirt paths, grass or trails, rather than concrete or asphalt. Always make sure your running shoes are the right fit and support for your gait by going to a speciality running store and getting a properly fitted pair.
Ensure your training programme is right for your ability, for example don’t start by running 10 miles a day build up to it gradually to allow your body to become accustomed to the training. Lastly, foot-strengthen exercises can go a long way to reducing future injuries. Tight hip flexors, a weak core and a history of low back pain can all contribute to injury – any of these issues can lead to subtle changes in your stride that you’ll feel in your feet. Have these issues addressed with physical therapy and a rehabilitation programme.
If you are experiencing pain when running and you think you may be suffering from plantar fasciitis contact the physiotherapists in Leeds and surrounding areas. Our fully qualified staff can help not only relieve the pain but help you make a full recovery.