A Guide to Plantar Fasciitis — Aspiring Family Chiropractic

“Running is nothing more than a series of arguments between the part of your brain that wants to stop and the part that wants to keep going” - Unknown.

It is official. I am running, for the first time since the heyday of my youth. At the start of this lockdown period a friend of mine set me a running challenge and not too long after accepting it came the onset of pain and inflammation in the arch of my foot. AKA. Plantar Fasciitis.

What is it?

The Plantar fascia is a thick fibrous band of tissue under your foot that runs from you heel to your toes. Irritation and physical stress to this area can create pain and inflammation causing the condition Plantar Fasciitis. It is characterised by pain in the heel, or in my case, the arch of the foot and is one of the most common musculoskeletal conditions affecting one in 10 people at some point. It generally doesn’t cause any pain with movement and in fact walking may actually reduce the pain, however the discomfort is usually more noticeable on the first few steps after resting or near the end of the day.

It is not always clear what causes this to happen but common reasons might include exercising on hard surfaces, poor cushioning or lack of support in shoes, a recent increase in the amount of walking (or running as in my case), tight calves or feet, or being overweight. I also have flat feet which is likely to have predisposed me to the condition as well as my significant increase in running.

While I have been busy managing my foot fascia, I decided it might be useful to put together something of a guide that could be helpful to others.

Here goes.

STRETCHES

Stretches to the calf and plantar fascia have been shown to help. Examples of these are shown below. Hold them for 10 seconds and repeat 10 times. Do this a couple of times each day or before and after exercise.

SELF MOBILISATION OF THE PLANTAR FASCIA (My personal favourite)

Get yourself a myofascial release ball (hello K-mart), or a tin of beans, rolling pin, golf ball, or anything similar. Roll your foot over the top of it in different directions for a few minutes concentrating on the painful areas. Do this a couple of times a day.

STRENGTHENING EXERCISES

Recent research has shown that strengthening exercises can be more beneficial than stretches, especially long term. Below is an example of a great strengthening exercise for this area.

Put your foot on the edge of a step with a towel placed under your toes. Slowly, for the count of 3 seconds, lift yourself up onto your toes. Hold at the top for a count of 2 seconds, then slowly lower down. Your heel should come below the edge of the step.

Aim to perform 3 sets of 12 repetitions. This might be very difficult at first so listen to your body and just do as many as you can manage. Do this exercise every other day to allow a period of recovery. Please note, like any strengthening exercise this can cause discomfort whilst the body adapts to the changes.

FOOTWEAR AND INSOLES

Wear footwear that is comfortable and has plenty of room for your foot. Using insoles that support the arch of the foot and provide some cushioning can help.

This is what I have been doing diligently for the last little while. Pre and post run I make sure that I stretch well, my calves as well as the plantar fascia under my feet. Every day that I run I also use my myofascial release ball to roll out the fascia. This honestly works a treat. This is enough to keep on top of the condition and prevent any pain. What I am continuing to work on is strengthening the band as well as performing small foot exercises to help with my foot biomechanics (due to having flat feet).

If you have not had the pain for too long than following the above advice can help in many cases. However sometimes the pain can persist and for some people it can be present for months, or even years. In this case, the following options could be of use.

An assessment with a health professional for some manual therapy, taping and a bespoke exercise program.
You could consider some custom orthotics. However there is limited evidence that these are much better than generic ‘off the shelf’ options.
Shockwave therapy. This is where the nerves sending pain to the brain are stimulated to such an extent that their activity decreases, thereby reducing pain. This is a relatively recently researched option but the initial studies are showing positive results.
Steroid injection. This can be very effective in reducing pain in the short term; however, it is only short lived with the pain returning not long after. There is also some risk of rupture and increased pain after.
Surgery. Rarely surgery maybe required however this should only be considered if the pain has been there for a long period of time and has not responded to other treatments.

That’s it for now. If you need anymore tips & tricks, don’t hesitate to get in touch. Meanwhile, enjoy this forced slow down & stay safe in your bubble.