STRATEGIES TO COMBAT PLANTAR FASCIITIS
Plantar Fasciitis is one of the leading causes of injury in runners. This insidious affliction can leave many a runner sidelined from training and seems to linger for an absolute eternity. For runners, this injury is often caused by sudden increases in training volume or intensity, poor foot or ankle mechanics, and inappropriate running shoes, all of which can overload the plantar fascia (the connective tissue that runs from your heel to your forefoot), resulting in arch or heel pain.
The plantar fascia is made of collagen, a rigid protein that doesn’t have much give. Through stress and overuse tiny tears can develop in this fascia, causing tissue death that can lead to pain and compensatory patterns of movement.
Plantar fasciitis sufferers typically feel a sharp stab or deep ache in the heel or along the arch of the foot. Another sign of the condition morning pain you may experience as a result of your foot trying to heal itself in a contracted position overnight. Taking that first step out of bed causes the partially repaired tissue on the bottom of your foot to stretch and tear, resulting in pain in your heel or arch.
Plantar Fasciitis is often caused by bio-mechanical issues, including unstable feet or ankles and tight calf musculature. This condition can often last for months because the healing response is proportionate to blood flow. When something has a good blood supply like a muscle, it heals rather rapidly, but the plantar fascia recieves little blood supply so the healing process can be delayed
TREATMENT STRATEGIES
Footwear And Supportive Inserts
For many runners, especially those with flexible arches, stabilizing the foot can produce remarkable results in treating this condition. If the fascia is constantly being stretched and torn it is very difficult for the area to heal. Supportive footwear and inserts that correctly stabilize the foot can help to immobilize the fascia and allow it to heal. Many individuals grab soft cushy inserts because they feel good, while these inserts may provide momentary relieve, they do little to address the issue in the long run. It is vital that hyper-mobile feet are properly supported for healing to occur.
Proper Dorsiflexion
Some studies have found a connection between poor ankle range of motion, especially in dorsiflexion, which implies that calf tightness plays a role in the development of plantar fasciitis. Improving dorsiflexion and loosening tight calf muscles through techniques such as massage and dry needling can be a very effective treatment strategy.
Night Splint
A night splint is another treatment which aims to stretch out the plantar fascia and the calf musculature. As its name suggests, a night splint is a device you wear while you sleep which keeps your ankle dorsiflexed. There are both soft casts and socks (such as the strassburg sock) that can properly hold the foot in a dorsi-flexed position.
Don’t Neglect Daily Footwear
What shoes you wear when you’re not running can also make a big difference. Arch support and shoe construction is key, and walking around barefoot or in flimsy shoes can really delay recovery.
Strengthening Weak Muscles
We often see that sufferers of plantar fasciitis often have reduced strength and balance throughout the leg, hip, foot and core. A key element to successful treatment of plantar fasciitis in runners often involves restoring both global strength in the leg and local strength in the foot to reduce abnormal loading patterns across the heel and arch of the foot. One technique is strengthen the instrinsic muscles of the foot through exercises that activate the ‘foot core.’ Several studies have shown that individuals with plantar fasciitis have atrohpy in their intrinisic foot musculature and an impaired ability to activate these muscles. A physical therapist can help to assess your imblances and guide you through exercises that will help to stabilize your foot.