That Pain in Your Heel: Treating and Preventing Plantar Fasciitis
Plantar fasciitis (“PLAN-ter fash-ee-EYE-tus”) is very common cause of heel pain, and a common issue for runners/walkers. The plantar fascia is the flat band of tissue (ligament) that connects your heel bone to your toes. It supports the arch of your foot. While running or walking, the plantar fascia works with the Achilles tendon to store and return energy. A strained or overstressed plantar fascia can get weak, swollen, and irritated (inflamed). The base of your heel will hurt when you stand, walk or run.
Although plantar fasciitis may result from a variety of factors, including a particularly stressful workout, hill repeats or tight calves, many sports specialists believe the most common cause of plantar fasciitis is low/fallen/incorrectly supported arches and weak stabilizing muscles in the foot. Excessive lowering of the arch in flat-footed runners increases tension in the plantar fascia and overloads the attachment of the plantar fascia on the heel bone. Supporting muscles in the foot, specifically the flexor digitorum brevis muscle (FDB) serve to help take the load of running or walking off of the arch, and if weak won’t adequately do this job.
As is the case with many soft tissue injuries, you may need to adjust both the volume and intensity of your training to give the area time to “heal”. As your’re resting your foot, you should spend some time stretching/strengthening your feet and lower leg/calves. A quick google search for “plantar fasciitis” cures nets hundreds of contraptions and five point plans. Some have more merit than others. The list below highights commonly accepted approaches.
- Arch support and wearing inserts in your shoes
- Changing shoes
- Taping the arch of the foot when walking or running
- ART or massage
- Rolling (with a ball) and stretching the foot
- Rolling (foam roller) and stretching the calves
- Strengthening exercises
- Wearing a splint at night to hold the foot in a semi-stretched position
- Medical treatments like cortisone injections or electro-stimulation
Changing your footbed
The single most important thing you can do is to alter the footbed of the of the shoe you’re running or walking in to adjust the stress points on your foot. You can do this either with an insert, or simply get a new pair of shoes. For many people a more supportive shoe or structured insert is the way to go and for others more flexibility is needed. Your best bet is to have an expert at your local running shop evaluate your mechanics and suggest some options.