Made of collagen, a relatively inflexible protein, the plantar fascia is the connective tissue that runs from your heel to your toes. The fascia can become inflamed resulting in heel pain. A sharp pain or deep ache can also appear along the arch of the foot. Most athletes will notice discomfort through the foot first thing in the morning. This occurs because the foot has contracted and tried to heal in a shortened position during sleep and that initial step out of bed lengthens the tissue. A similar feeling can be experienced after prolonged sitting. Often the pain subsides after the area is warmed up which is why athletes may notice things feeling better mid-run. However, given how much we use our feet and contract/ extend against the healing process, plantar fasciitis can become a nagging problem lasting many months.
Physiotherapist Garfield Andrews, the owner of Universal Integrated Health in Toronto, says the injury is very common. “Notwithstanding a traumatic event, plantar fasciitis often originates from a biomechanical issue involving general hip or ankle instability. This leads to symptomatic tissue disruption at the bottom of the foot (plantar fascia). Stretching and strengthening hips and ankles, along with general symptom management should alleviate the issue within 1-2 weeks.”
Andrews suggests that strengthening the glutes can make hips more stable, and advises paying particular attention to the gluteus medius. Additionally, he recommends stretching and strengthening the calf complex (gastrocs and soleus), particularly the medial gastrocs. Andrews says that runners in particular (and that means triathletes too!) should also strengthen the inverters of the foot and medial arch for increased stability.
Do it Yourself Treatment for Plantar Fasciitis:
-Switch to running on softer surfaces such as the Beltline or the ravines. Avoid running on asphalt or concrete.
-Ditch your high heels for a while, or minimize time spent standing or walking on hard floors while in heels.
-Massage and stretch your calves. While seated or standing, massage your foot with a golf ball (roll your foot over one while controlling the pressure you exert through your leg).
-Reduce inflammation by soaking your foot in a bucket of ice water. You can also try ice massage (roll your foot on a frozen water bottle).
-Night splint options are very effective but not particularly comfortable. These include the sock and the boot.
*Many runner’s shops will stock the sock. You may have to ask your physio or chiro to order the boot which is slightly more aggressive.
More difficult cases could benefit from any number of modalities (such as ART, Acupuncture, ultrasound) offered by your physio or chiropractor. Severe cases could benefit from Shock Wave therapy, PRP (Plasma Rich Platelet) Injections, or even surgery. If pain persists beyond 1-2 weeks, as Andrews suggests, seek medical advice to identify where the problem is originating, get treatment options, and target a routine to strengthen feet, ankles, and hips.