Plantar Fasciitis: A Runner's Guide to Pain-Free Miles
As a runner, few things are as frustrating as being sidelined by plantar fascial pain, more commonly referred to as plantar fasciitis.
Many of us have experienced it at some point…that sharp pain at the front of your heel or along the arch of your foot that feels like an icepick during the first few steps in the morning. That pain that often lingers and nags throughout the day turning even the simplest of runs into a struggle. But fear not, fellow runner!
With the right approach and understanding, you can overcome plantar fascial pain and get back to doing what you love without surgeries, injections, or months of rest on the couch. As a performance physical therapist specializing in treating runners, I'm here to guide you through the ins and outs of managing and preventing plantar fascial pain.
Understanding Plantar Fasciitis:
Before we dive into treatment and prevention strategies, let's take a closer look at what exactly plantar fasciitis is and why it's such a common issue for runners. The plantar fascia is a thick band of tissue that runs along the bottom of your foot, connecting your heel bone to your toes. When this tissue becomes inflamed or irritated, it can result in sharp, localized pain on the bottom of your foot. However, not all “plantar fasciitis” is created equally, which is why many physical therapists, including the team at Samson Strength and Performance PT, tend to prefer the terms plantar fascial pain or even plantar fasciopathy.
Causes of Plantar Fasciitis
Several factors can contribute to the development of plantar fascial pain. First and foremost, it’s helpful to visualize this pathology as a loading issue. So regardless of your specific activity, from running to working on your feet all day, if the tissues in your feet and ankles are not robust enough to handle the loads you are placing on them, you are setting the scene for the development of pathology and subsequently more likely to develop pain. Which tissue specifically is leading to the load management issue can vary from runner to runner including: poor eccentric control of the posterior tibialis muscle, overuse of the gastroc/soleus complex, or even mobility deficits of the joints of the feet. If you compound these tissue based factors by adding in improper footwear, inefficient poor running form, and sudden increases in training volume, it’s no wonder why some people develop pain!
Treatment Strategies for Plantar Fasciitis
The clinical diagnosis of which specific tissues are involved plays a large role in how we choose to rehabilitate each runner. While plantar fascial pain can be a stubborn injury, there are several effective treatment strategies that can help alleviate pain and promote healing:
PEACE and LOVE: Contrary to what your old coach might have told you, the RICE method of Rest, Ice, Compression, Elevation is no longer the most effective strategy in the face of soft tissue injuries. Instead, try PEACE and LOVE:
Protection: avoid activities that increase pain
Elevation
Avoid anti-inflammatories as they reduce tissue healing
Compression
Education: avoid unnecessary passive treatments
and
Load: gradually increase your return to activity based upon your pain
Optimism: stay confident and positive that you will return to your sport
Vascularization: increase blood flow to the affected area through pain free movement
Exercise: restore strength, mobility and proprioception by adopting an active recovery approach
Manual Therapy: Physical therapy techniques such as trigger point dry needling, instrument assisted soft tissue mobilization and joint mobilizations can help improve foot and ankle mobility and reduce your overall pain experience.
Footwear: Be intentional about what shoes you wear for the specific activities that you perform. While we often promote a more minimalist style shoe for strength training, there is a time and a place for some motion control in your footwear. Choose a foot-shaped shoe that provides you with the level of arch support that you need at this point in your journey.
Running Form: While there is no one-size-fits-all running form that cures all pains in all runners, there is evidence that some gait characteristics lead to injury less frequently that others. Among these are: type of footstrike, foot position at initial contact, cadence, and shin angle at initial contact.
Plantar fasciitis pain is a common challenge for runners, but it doesn't have to derail your training or dampen your love for the sport. By understanding the causes, symptoms, and treatment options for plantar fascial pain, as well as implementing preventive measures, you can keep your feet happy and pain-free mile after mile. Remember, patience, persistence and progressive loading are the key to overcoming any overuse or load management injury.
Happy running!
Looking for help with your running form?
At Samson Strength and Performance PT, we can help you not only improve your performance in Running, but also help you get rid of your plantar fasciitis for good. Request a free call by clicking the link below. We’d love to help you.
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