A Runner's Guide to Plantar Fasciitis
I like to run. I am one of ‘those’ people; that kind of person that finds freedom and joy and challenge in doing something, which at times can be, monotonous. Unlike most athletic endeavors I am not creating an attacking play or defending a goal or quite frankly chasing anything or anyone; but I will surreptitiously beat you to the next tree or fictitious finish line if you’re running on the trails at the same time. That being said I will also take my time to enjoy a sunset on a cheeky hill up Whitemud Ravine, or let my heart melt over any dog whose owner is gracious enough to let me pet it. So it is incredibly frustrating when something, specifically an injury, prevents me from pursing all that is running. Many runners and non-runners alike suffer from one injury in particular: plantar fasciitis, also known as joggers heel/foot.
WHAT is plantar fasciitis?
Simply put plantar fasciitis is degeneration and irritation of a fairly robust bowstring-like connective tissue on the bottom of your foot. It assists in maintaining your foots arch while acting as a dynamic shock absorber, essentially assisting in the distribution of forces placed on the foot when weightbearing.
WHERE is plantar fasciitis?
The plantar fascia, more aptly aponeurosis, connects from your calcaneus (heel bone) and spreads to the heads of your metatarsals (the bones before your toes). The most common location of pain is near the heel and that discomfort may radiate down the arch of your foot. One of the defining aliments is discomfort during the first few steps after waking or sitting for a long period of time, which will eventually lessen with continued walking. Although it generally feels worse when weight bearing.
WHY do I have plantar fasciitis?
Now that is a loaded question.. speaking of load, the plantar aponeurosis is built to tolerate a given capacity that is unique to both you and I based on a variety of factors; previous training/fitness/walking volume and capability, individual biomechanics, BMI, footwear, genetics, etc. When we exceed this capacity (or do something it’s not use to) the likelihood for injury, or in this case degeneration and irritation, may increase. A good question to ask yourself is have I recently changed any of the aforementioned factors?
HOW do I treat plantar fasciitis?
Our job is to increase the capacity and improve your plantar aponeurosis’ tolerance to load. So first and foremost let’s head back into the “why” this may have happened. It is likely a unique problem, which is why being assessed by a Physiotherapist can be helpful in guiding which direction you take. Perhaps you are asking your plantar fascia to do things it typically isn’t responsible for. Possibly the unnecessary load absorbed by your plantar fascia is stemming from an issue in your ankle, knee, hip or even biomechanics during running or walking or jumping. Initial modification of activity (this does NOT mean rest!) with progressive overload principles guiding rehabilitation is a great place to start. Fascia may remodel itself based on mechanical demand. There has been research suggesting that the windlass mechanism, extending the big toe upwards, tightens the plantar aponeurosis . A calf raise utilizing this principle could be useful in pain reduction. Other exercises such as toe yoga, a windlass toe stretch and improving ankle mobility continue to show symptom relief. Ankle mobility can have restrictions in either (or both) the joint and soft tissue. Dry needling or performing soft tissue release on the calf can assist taut bands of tissue to relax or desensitize their overactivity. There is conflicting evidence regarding rolling, often called self-myofascial release, the plantar fascia as it’s a fairly inextensible tissue. Regardless my general rule of thumb remains as long as you’re not causing yourself pain, it can be helpful to create short term range of motion gains and desensitize the small intrinsic muscles of the foot that often get overlooked.
I hope this brief overlook on all things plantar fasciitis gave you the confidence to begin your rehab or even prehab to get you back to the activities you love! Feel free to contact us if you have any questions. And to my fellow trail runners, I’ll see you 2 meters away…
Jessie Brown
Hi, I’m Jessie! Edmonton born and raised, I am a graduate from the University of Alberta with a Bachelors in Kinesiology and a Masters in Physical Therapy; along with holding post-graduate training in Biomedical Dry Needling. While attending the UofA I played and captained for the Pandas varsity soccer team; and twice represented Canada at the Universiade games. Read More →