by Mitchell Starkman, Registered Physiotherapist
Now this one is a big topic, folks. Our foot is not only the first thing to contact the ground when we run, but also our only means to generate force to propel ourselves forward while running. When it comes to foot pain for runners there is one condition that by far outweighs the others and that is Plantar Fasciitis. There are a few other common causes of foot pain in runners, like fat pad syndrome–even a stress fracture–but given that the number one killer of a runner’s season is Plantar Fasciitis, that will be our focus today.
Our goal is to cover three general questions to give you all the info you need to solve this age-old question.
- What is Plantar Fasciitis and why do I have It?
- How do I know if I have this issue?
- How do I fix It?
What Is Plantar Fasciitis?
Alright, so let’s get started with what Plantar Fasciitis truly is and then we can take a deeper dive into why you may be struggling with it. The Plantar Fascia is actually a structure that runs along the sole of your foot. Anatomically, it begins at the base of your heel and fans out to connect to the big toe and all the way across to the pinky! It’s important to note that we do have fascial connections that actually run from the base of the foot and connect to other muscles like your calves and hamstrings–we can’t forget about these areas when tackling this issue!
Now, what the term Plantar Fasciitis is referring to is the inflammation or irritation of the tissue that is actually attaching to the base of the heel. This is the point where the majority of the force is being applied when we push off the foot, and unfortunately, the most likely to break down.
Generally speaking, this is an issue of overloading. The tissue at the base of the Plantar Fascia is unable to withstand the weight you are placing on it and so…it hurts! We will dive into some possible options as to why that might be the case in the next section.
Why Did I Develop Plantar Fasciitis?
Why you? Well, let’s break this down into a few major contributors to the issue.
- Over Training. If you’re like a lot of runners, you love to run. This means, of course, that you may like to run often! Simply put, if you go from never running to running 10 km, 5 times a week, or from running a total of 15 km a week to 30 km overnight, you are bound to have some hiccups along the way. One of the most common cases I see are folks who take a few months off of running, due to injury or time commitments, and jump right back into things at the same distances they were running previously. The body just isn’t ready for this kind of overloading. Our bodies and our tissues need time to adapt to the progressive loads. So one of the first things you want to do is evaluate your current training load and see if you may have increased things too quickly.
Poor Mechanics. This is the part that may involve some stretching or strengthening when you’re not running. Our tissues like to be loaded in a direct and straight angle to maximize their effectiveness. If you’re running with your foot turned out, collapsing your arch (overpronating), or your knee is caving in, you’re going to be altering the angle at which the plantar fascial is loaded.
If you are pulling on the Plantar Fascia more on the left side than the right, or vice versa, that my friends, is a problem.
Most commonly, the issue here is that these poor mechanics can be directly caused by weakness in your arches and hips, along with stiffness into ankle dorsiflexion (bending up towards you). The good news is that PhysioReady has created an online program that tackles all of this available through the Running Room.
- Wrong Footwear. This may be part of the problem, but it is rarely the fix. Having the right support (or lack thereof) for your foot is crucial, but it is likely just a piece of the puzzle. Most likely you could benefit from reviewing your mechanics as discussed above.
- But how do I know what the right shoe is for me? This is something that a Physiotherapist, or your local Running Room, can give you some insight on.
How Do I Fix It?
Since there are so many potential underlying causes, the first challenge is to figure out what to do first. As with any medical issue, the first thing to do is get checked out by a healthcare practitioner that you trust, such as your family physician, to gain a proper diagnosis of your condition. After you have diagnosed the problem, you can figure out what to do to correct it. This means finding out which exercises are best for you and your condition. This can be accomplished by going to a clinic to see a physiotherapist, rehab specialist, or with a proper diagnosis, you can use an online tool like PhysioReady to address the injury and begin the healing process.In the meantime to get you started, we’ve included some basic exercises to help address the underlying issues, whatever they might be!
This is an amazing way to get more movement and mobility into your calves and ankles. It may not seem like it, but better ankle movement means much happier and healthier feet and Plantar Fascia!
Glute strength is SUPER important here. Now, both of these strength exercises are non-weight bearing. Why? Because we want to offload the foot as much as possible while we strengthen up the weak areas. Once your strength has improved you will be more able to maintain alignment during your run and put less stress on the Plantar Fascia.
Who Should I See to Treat my Plantar Fasciitis?
A wide variety of health care providers can help you to treat this issue. If possible, seeing a sports medicine physician is a great place to get accurately diagnosed and, for most of you, this will be covered. Once you have a more accurate diagnosis, we recommend you enroll in the PhysioReady program and get started on your road to recovery! This is a easy and convenient way to get started on the road to recovery.
For those of you who prefer a more hands-on approach, find a licensed physiotherapist or orthopedic specialist right away to get assessed and get started!
Plantar Fasciitis is the inflammation and irritation of the Plantar Fascia at the base of the heel. This occurs when it is being repeatedly overloaded due to overtraining, friction in the kneecap, poor mechanics or footwear and this begins causing pain. When it comes time to tackle this issue from home, the best place to get started is with the Affordable PhysioReady Plantar Fasciitis program.
Mitchell Starkman is a Toronto-based Physiotherapist with a passion for sports, orthopedics, and human movement. Mitchell’s goal is to understand how the site of pain is impacted by the entire body– rather than pinpointing a specific disturbance. He is also the founder of www.TheMovementCentre.ca – a website which provides people the tools they need to self-manage, treat and prevent their injuries.