Running with Plantar Fasciitis
Plantar fasciitis is one of the most common sources of heel pain that we encounter here in physical therapy. In fact, it’s estimated that around 10% of the population will experience heel pain at some point in their lives. For runners, the pain can be extreme as the act of running actually generates 3-5 times for your body weight in impact force per footstrike. Think about how many times your foot makes contact with the ground on a run! Runners without adequate muscle strength or flexibility can overload their plantar fascia, that think band of tissue that runs from the heel bone to your toes and supports the arch of the foot. When the plantar fascia becomes irritated, inflamed or weakened by injury, every step can be painful.
In addition to repetitive heel striking, there are a few possible causes of plantar fasciitis:
- Decreased ankle range of motion, particularly into dorsiflexion (flexing the foot upwards)
- Elevated Body Mass Index (BMI)
- Improper footwear
- Prolonged standing and weight-bearing activities throughout the day
As a runner, you’ll know that you have plantar fasciitis if you experience tenderness at the heel, pain along the arch of your foot and/or pain as you take your first few steps in the morning. One telltale sign of plantar fasciitis is experiencing pain as you begin to walk after being stationary for a long period of time. This occurs due to a tightness in your calves and the fact that your foot and ankle stay in one position during the night.
If you’re one of the fortunate ones reading this who is NOT experiencing symptoms of plantar fasciitis, this probably sounds pretty terrible. If you are experiencing heel pain, luckily there are steps you can take (pun intended!) to get rid of symptoms so you can return to pain-free running again!
So what can you do on your own to reduce or eliminate plantar fasciitis pain? First, focus on stretching the plantar fascia and calf complex several times a day. There are a lot of beneficial exercises available that can easily be done in just a few minutes. Try these to start. Additionally, try out specific exercises that target the hips, core and lower extremities. Next, you can try orthotics (aka insoles). Orthotics can be huge in helping you correct mechanical errors in the foot and ankle to restore full function of the feet.
If you find that your heel pain is persisting, physical therapy is a great option to quickly alleviate the primary symptoms of the foot. While there is no “one size fits all” treatment for plantar fasciitis, physical therapists are experts in assessing and treating all musculoskeletal dysfunctions that cause plantar fasciitis and can be your resource for treatment. They can also advise you on proper footwear to help and minimize foot pronation. With manual therapy techniques, your physical therapist will address motion restrictions in the foot, ankle and calf to relieve your plantar fasciitis pain. They’ll also work to mobilize stiffness in the ankle/foot complex and other tissues. They may utilize joint mobilization, soft tissue massage and other hands-on techniques as well for rapid improvement in heel cord and calf mobility. Your physical therapist can also perform a video run analysis to assess your gait and assist in correcting any biomechanical concerns.