Pains of an Athlete: Plantar Fasciitis

Plantar Fasciitis can be a devistating ailment that can keep an athlete (or anyone else for that matter) sidelined for a long time if not treated properly.
Note: This is non-medical advice, information provided is from my own research and experience dealing with my own issues of plantar fasciitis.

What is it? It’s the inflamation of the Plantar Fascia ligament under the arch of the foot. Typically this inflamation causes pain at the heel of the foot under pressure, especially during one’s first steps in the morning. Pain typically subsides during the day.

What causes it? There is no one certain answer; worn out shoes, wrong shoe type for your running style, overload of physical activity or exercise…excessive running. Even muscular imbalance can be a contributing factor.
What are common methods of treatment? Again, there is no one certain answer; everyone reacts differently to each treatment method.

Self Treatment

  • The Obvious. Rest or stop running!
  • Stop Using Old Shoes. Get a new pair that is correct for your running style.
  • No/Low Impact Exercises, such as elliptical trainers and pool jogging. These will keep your cardio levels up and also work different muscles that are typically used by triathletes.
  • Stretch The Plantar before your first steps in the morning. Sit on the bed, cross you leg with effected foot on your knee. Curl toes upward as far as you can and use your hands to curl even further. With your other hand/thumb apply pressure to the plantar ligament at various points along the arch and heel. Repeat this 3-4 times throughout the day.
  • Ice. Fill a Gatorade bottle with water and freeze. Once frozen, use to roll your foot/arch over it. Apply downward pressure while foot is rolling over it. Do this 3-4 times a day.
  • Stretch The Calf. The plantar actually runs up the back of the calf, so the calf muscle must also be stretched. Any calf stretch will do, search Google or Youtube for examples.
  • Stimulate the Fascia. Fascia is strong connective tissue which performs a number of functions, including enveloping and isolating the muscles of the body, providing structural support and protection. Stimulating the plantar fascia and calf area fascia will draw new blood to the area. Fresh blood aids in recovery. Use a firm ball that is the size of a tennis ball or slightly larger. Place the ball under the arch of the foot, swirl your foot around keeping the ball under the arch. Apply downward pressure while moving the foot around. This is also good under the calf muscle. Sit on the floor with your legs out, place ball under the calf, swirl your body around by lifting you butt off the ground. The ball and your hands are the only contact point with the ground. You may need to place the ball on a slightly elevated surface for full effectiveness. A rolling stick is another option.
  • Specific Exercises. Using an elastic band, place slightly above the ankles, side step laterally about 10 steps each side. Feel the inner thighs and glutes working. Running is a forward movment and this is a great change up to get the body moving laterally (sideways). Another exercise is single leg dumbell or kettle ball squats. When squatting, keep head up and don’t let the knee travel too far forward. This is great for increading balance and core strength. Plantar Fasciitis need more than local treatment; legs, glutes and back all need to be strengthened and stretched.

  • Off  The Shelf Products. I use the Strassburg Sock, shown here, at night (www.thesock.com). It keeps tension on the plantar fascia so it heals in a stretched position. Heel cups with gel to absorb impact, plantar/arch straps that apply tension to the plantar ligament which can be worn during exercise. Insoles, off the shelf orthotics or custom orthotics. Your foot sturcture may be changing.
  • Prayer. That right, understanding and believing in a higher power can do wonders.

Medical Treatment
Results may vary, and do not work for everyone. Consult your physician on treatment options!

  • Physical Therapy such as ART to assist with ligament stretching and regeneration. Gastron Technique is another treatment method, a special stainless steel instrument that is precisly rubbed along the plantar ligament. This causes micro abrasions and stretches the ligament and the body reacts by sending fresh blood to the area to assist with the healing process.
  • Kinesio Tape. Special tape that is used to compress or decompress muscles. RockTape (www.rocktape.com) is great and is specifically designed for usage with endurance athletes.
  • Cortisone Injection. Is a temporary anti-inflammatory injection. The pain goes away because the inflamation is reduced. This teatment doe not address the underlying problem.
  • Platelet-Rich Plasma Therapy. Injection of your own blood platelets directly into the effected area to help repair damaged tissue.
  • Laser Light Therapy. This low intensity laser light stimulates the effective area, encouraging new blood to be drawn to the effective area…faster healing.
  • Surgery. The last resort, however this may not solve the problem!

My write up was originally published in Triathlon Club of San Diego’s December 2009 newsletter

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