Plantar Fasciitis - What Do I Do Now? - Tracy Dowell
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If you think you might have plantar fasciitis (PF), having had it a few times in my life, I want to convey my deepest sympathy to you! Being a runner for most of my life and working in the running industry for over a decade, not only do I talk with my peers, fellow athletes, and clients on a daily basis about this topic, I have also successfully sought therapy from professionals and self-treated my own PF! I now recognize the little, tight twinges that signal a flare-up and pounce on those like a runner on Chicago Marathon's open registration site!
"Plantar fasciitis is one of the most common causes of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes (plantar fascia). PF commonly causes stabbing pain that usually occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting. The pain is usually worse after exercise, not during it.
Your plantar fascia is in the shape of a bowstring, supporting the arch of your foot and absorbing shock when you walk. If tension and stress on this bowstring become too great, small tears can occur in the fascia.
Plantar fasciitis is more common in runners. People who are overweight and those who wear shoes with inadequate support also have an increased risk of plantar fasciitis." - mayoclinic.org
With regards to runners and walkers, we often see PF appear from overuse activities and/or an increase in activity over a short amount of time. We also see clients who are on their feet all day on concrete in their work environment. Training for a half or a full marathon? Following your kids around the uneven, grassy cross-country course on a Saturday morning? Been there! Have you ever exited from the car at work and noticed the tightness set in...and felt as if you needed a cane to get across the parking lot into the building? Heel pain? Ball-of-foot or outside foot pain? Plantar fasciitis can present in a few different ways.
While speaking at a continuing education conference for medical professionals, I listened to a fascinating lecture by an orthopedic surgeon who stated that nearly all of plantar fasciitis and achilles problems stemmed from tight calves. That's right, the knee bone is connected to the...it's all connected, and thus the need for strengthening and stretching the whole body.
Kirsten Transue of Physiotherapy Professionals: "Here are the basics to start with: Wear support shoes at all times (especially when first getting out of bed when foot is really tight), do gastric and deep calf stretches (runner's stretch with knee straight and knee bent) stretch big toe back. Do stretches 4-5 times/day. Wear a night splint. If still struggling we can use various modalities to help (dry needling, cupping, Graston)...call us if needed, 217-546-3301!"
*Can I still run and exercise with PF? Yes! Though, it can take longer to heal if you are re-injuring it. Rest may be necessary. The key is to get on top of the problem and start therapy on yourself or see a professional to work through the pain and strengthen the legs and feet.
Things that have helped me:
~First plantar fasciitis affliction: I had one month left in training before Boston Marathon, so I saw a podiatrist, and he recommended custom, 3/4 length hard orthotics for my flat feet. I ran in those rigid, concrete beauties for years, and it took nearly a year to get over! Orthotics can and do help some people, and they certainly help me with my flat feet! You don't have to go with expensive, custom orthotics these days, as physicians send their patients to us to professionally fit them for over-the-counter, premium orthotics from brands such as Powerstep, Sole, Spenco, Currex, Aetrex, Superfeet, and Cadence (which are made by a physical therapist for running specialty stores). We can also help you find great, supportive shoes to aid your recovery!
~Second PF affliction, a few years later (and the other foot): I sought physical therapy, and we hit it hard! I was already seeing a chiropractor for my back, and I was to run another marathon within a month. She turned her focus to my foot and scraped, stretched, performed ultrasound submersed in a hot tub of water, and followed all of that with ice! She said that the hot water treatment helped to relax the tissue, increased the blood flow and allowed for better stretching of the tissue, while ice was great for after my workouts and work day to relieve the pain and inflammation. I stretched and massaged my calves several times a day and soaked my foot in a small tub of hot water with a golf ball for self-mutilation twice a day from home. This time I got over it in about two months.
With the physician-engineered, patent-pending stretching board in stock at all times, we show our customers and clients how to stretch those calves and perform calf-raises to strengthen everything down to the toes and in between! Jeff (SRC) and I are huge fans of the PF compression sleeves for the feel of being professionally taped and pain relief all day long.
For sleeping, the Powerstep Ultrastretch NightSock is a great way to keep the foot tilted at a 90 degree angle to help keep it from tightening up as you sleep.
Finally, it can take 6-18 months to find complete relief from plantar fasciitis without treatment. But with the right tools, consistent nonoperative treatment, strengthening exercises, as well as physical therapy from a professional when needed...you can be "back on your feet" sooner than later!
