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Run Well: Plantar Fasciitis

 

We are excited to kick off a new series in partnership with Sports Injury Clinic.  www.sportsinjuryclinic.net   This site has been a well used site by me over the last year as I have worked through various injuries.  It provides the right amount of detail about the injury and tips on treatment as well.   And while we hope you don't have the need for the resources, we are pleased to offer articles in tips in the event you are dealing with a running injury.

 

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Plantar fasciitis is a common running injury, resulting in pain under the heel and arch of the foot. The plantar fascia itself is a broad band of thick fibrous tissue (fascia) which runs from the heel bone (calcaneus) to the forefoot. Its function is to support the arch of the foot and to provide some rigidity to the foot for the propulsion phase of gait.

 

Plantar fasciitis is sometimes also known as a heel spur, although this is not strictly correct. A heel spur is a bony growth which forms under the heel, at the point where the plantar fascia attaches. A heel spur can be the cause of plantar fasciitis, although in many cases, there is not a heel spur present. Similarly, a heel spur can be symptom free.

 

The symptoms of plantar fasciitis include:

 

Ø      Pain under the heel which may radiate into the sole of the foot

Ø      Pain is usually worse first thing in the morning or upon standing after long periods of non-weight bearing

Ø      In the early stages pain usually fades as activity increases, although if the condition is left untreated pain may persist

Ø      Pain when pressing around the inside of the heel and sometimes along the arch

Ø      Stretching the fascia may be painful

 

What causes plantar fasciitis?

 

Plantar fasciitis is an overuse injury, meaning that it gradually comes on over a period of time. It is not caused by one sudden event. If this is the case, you are more likely to be suffering a plantar fascia strain.

 

The most common cause of plantar fasciitis is very tight calf muscles, which leads to prolonged, and / or high velocity pronation of the foot. This in turn produces repetitive over-stretching of the plantar fascia leading to possible inflammation and thickening of the tendon. As the fascia thickens it looses flexibility and strength.

 

Other causes include flat feet (pes cavus), high arches (pes planus), oversupination, or the wearing of unsuitable/unsupportive footwear.

 

Treatment

 

Treatment of plantar fasciitis can be difficult due to the near impossibility of completely resting the foot. However, relative rest from any excessive activities (i.e. running, long periods of walking etc) should be sufficient in all but the worst cases.

 

Ø      Apply cold therapy to the heel and arch of the foot 3-5 times a day for 10 minutes at a time

Ø      Apply a plantar fascia taping technique which will help take the strain off the fascia during day-to-day activities

Ø      Wear a plantar fasciitis night splint. This will help to stretch out the calf muscles and plantar fascia itself whilst you sleep. This is when the musles usually tighten up, causing pain first thing in the morning.

Ø      Take anti-inflammatory medication (always seek your Doctors advice first)

Ø      Gently stretch the fascia and calf muscles regularly throughout the day

Ø      Massage the fascia using a golf ball (or similar). Only do so if it is comfortable.

Ø      Purchase some insoles for your shoes. If you overpronate, get some with a medial arch support. If you oversupinate, get some shock absorbing ones

Ø      If you have a neutral foot (meaning you do neither of the above), consider using a heel pad (in both shoes so as to avoid a leg length difference!) as a temporary means of reducing pain in the heel.

Ø      Check your footwear isn’t worn out, and if it is....change it!

 

To stretch the calf muscles, stand facing a wall with a wide stance and the leg to be stretched at the back. Keep the heel flat on the floor and the knee straight as you lean forwards using your hands on the wall to balance you. This stretches the Gastrocnemius muscle, the largest of the 2 muscles at the back of the lower leg. To stretch the smaller Soleus muscle, just bend the back knee slightly. You should then feel the stretch lower down the calf.

 

To stretch the plantar fascia, gently pull the toes back towards you until you feel a pull in the arch of the foot.

 

With both of these stretching exercises you should hold the stretch for 20-30 seconds and repeat two or three times. Do this 3-5 times a day to get the most benefit.

 

We always advise seeking professional treatment in order to return to fitness as soon as possible and free from pain! A professional sports injury specialist may also:

 

Ø      Perform treatments such as ultrasound to aid healing

Ø      Use sports massage techniques to stretch out the calf muscles and plantar fascia

Ø      Undertake gait analysis to see if you overpronate or oversupinate and then prescribe custom orthotics

Ø      Shock wave therapy

Ø      Devise a full rehabilitation program

 

More extreme treatments include a corticosteroid injection, or surgery, although these tend to be last resort treatments, and should only be used after a lengthy period of thorough, conservative treatment.

 

For more information on plantar fasciitis treatment and rehabilitation, including a sports massage demonstration, taping technique and further exercises, please visit:

www.sportsinjuryclinic.net

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Comments

Cliff

There are many stretching exercises that help those who have plantar fasciitis.He may need an orthotic insert for his shoes. Also use of a medication such as celebrex will help. Sometimes a cortisone shot in the foot is required, Physical therapy and foot massages help.
But the good news is that it sometimes goes away on its own in 2 years time.
It is terribly painful in that you feel as if you are walking on glass and you get foot and leg cramps. But when it goes it is a great relief.

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