I love this time of year. The nights and mornings are a little cooler, and soon a jacket and jeans will be my go-to lounge clothes. But the weather, along with watching high school and collegiate cross country teams running in packs all over the city, is also motivation to get back outside and put my running shoes to good use again. If you’re like me, running when it’s 95 degrees and 75 percent humidity sounds less than appealing.
I must admit, I tend to gravitate to the gym or I stay inside on my treadmill on those days. Unfortunately, pounding the pavement after running on a more forgiving treadmill for a couple of months can also be a set up for injury, especially to the feet. One of the more common foot problems is plantar fasciitis — a big word for an annoying and painful condition.
What is plantar fasciitis?
The plantar fascia is a thick band of fibrous tissue located on the underside of the foot. It runs from the inside edge of the heel to the toes. The plantar fascia provides support to the arch, and acts as a shock absorber.
When the fascia is overloaded, pain can develop anywhere along the course of the plantar fascia, but most commonly the pain is located where the band of tissue attaches to the inside edge of the heel. With repetitive overloading and over use, the plantar fascia becomes irritated, starts to breakdown, swell and cause pain.
- Pain most commonly located at the inside edge of the heel
- Worse with the first step in the morning
- Generally improves with movement, and returns after periods of rest — sleeping or sitting for long periods
- Generally occurs with excessive weight-bearing activities, and while walking barefoot or in shoes without any arch support, such as flip-flops or sandals
Causes/risk factors include:
- Tight calf muscles
- Flat feet
- Recent increase or change in activity level
Evaluation by a sports medicine physician should include a complete history of your foot problems and a thorough physical exam. The physician will:
- Evaluate your gait and foot shape
- Determine flexibility in your foot and ankle
- Determine where the pain is located.
- If there is concern about a stress fracture in the heel, X-rays may be obtained.
- A physician trained in sport ultrasound like Via Christi can determine if there is thickening or tearing in the plantar fascia.
Treating plantar fasciitis usually involves multiple approaches. Athletes may require:
- Decreasing training or activities that involve impact to the heel. During this time, athletes can usually participate in alternative, pain-free cross-training activities like biking or swimming.
- Limiting the amount of time spent walking barefoot or in sandals
- A change in running shoes or the use of heel cushions, arch supports, or custom orthotics could also be beneficial.
- A short course of anti-inflammatory medication like ibuprofen or naproxen is typically recommended.
- Physical therapy is almost always recommended, where treatments like ice massage directly on the plantar fascia and stretching and strengthening of the foot and ankle muscles are commonly performed.
- Many physicians advocate for the use of a plantar fascia night splint, which helps to keep the tissue stretched out overnight.
- If the above measures have not been successful, a corticosteroid injection may be considered. Surgery is rarely required to treat plantar fasciitis.
Prevention tips include:
- The most important thing is to pay attention and be kind to your body.
- Use caution and transition gradually when changing your training intensity, training surface or shoe wear.