Plantar Fasciitis is a very common injury that we treat at PhysioWorksNI.
It can be very a frustrating injury as it can keep you out of running for a year or more!
What is Plantar Fasciitis?
The plantar fascia is a thick band of fibrous tissue that runs along the sole of the foot. Pain tends to be felt over the inside area of the heel on the sole of the foot. Pain will be noticied first thing in the morning, at the start and after running and after a period of rest eg. getting up after sitting for a while.
What causes the pain?
The pain is due to inflammation and/or structural breakdown (small tears) of the fasica due to repetitive micro trauma. Due to the nature of the fascia it can prove quite slow to heel.
Risk factors- What puts you more at risk of developing this injury?
1. Too much running! The tissue gets overloaded and breaks down
2. Alignment issues- eg Rolling of the thighs, over pronation/flat feet. Also a very mobile foot or tight feet can cause problems.
3. Inappropriate footwear
4. Not enough stretching. Back, hips and legs and feet get tight.
5. Not strong enough- core, gluts, legs and ankles.
Phase 1- This is all about clearing pain and swelling.
1. Ice to the painful area.
2. Supporting the foot to ease pain- taping, supportive shoes and possibly a night splint to keep the tissue lengthened throughout the night. Sometimes a simple arch support is enough however an assessment by a podiatrist is recommended who specialises in running injuries.
3. Stop all aggrevating activities- Stop running and if possible avoid standing for long periods.
4. Stretching- hamstring and calf stretches and foot stretches. Should go very gently at first.
5. Massage to calves and foot- Therapist and self massage.
6. Getting advice on foot position and how to help this improve with simple exercises.
Phase 2- Once pain starts to settle it is time to start strengthening and helping to improve alignment issues.
1. Core work - functional rehabilitation exercises tailored to each individual to help realign the pelvis, legs and improve foot position.
2. Strength work - generally needed to work on gluts, hamstrings, calf, ankle and foot muscles. If the leg muscles and the muscles around the ankles are stronger they help the plantar fascia from being overloaded.
3. Stretching - functional stretching- these are stronger stretches related to running positions.
You are able to start running again when you have- no pain first thing in the morning, no pain when walking and you can hop 50 times on the affected leg with no pain.
You need to gradually build up to running again, walk/run routines are great eg. couch to 5k programme is great. Keep to a smooth flat surface, avoidung hills until you can run at least 20 minutes without pain.
Prevention for the future.
To help with reducing the rick of developing plantar fasciitis follow these simple rules.
1. Stretch more regulary- especially after running.
2. Don't over train- listen to your body
3. Get a regular massage every 4-6 weeks.
4. Self massage to calves, inside shin area and feet. Can use a foam roller and a spikey ball.
5. Continue with core and leg strength work- once/twice a week. This will also make you a better runner!
6. Good running shoes that suit your foot position and buy new ones when you notice the soles starting to wear down.
7. Don't always run on the road, try to run on grass or trail for some of your training sessions.
8. Try to walk barefoot sometimes around the house.