by Geoff Rand
I’ve been fortunate enough to have never personally experienced Plantar Fasciitis, but I know people in and out of the Box who have, and I can tell you that it destroys you and affects every aspect of your life when you get it. Plantar Fasciitis sucks so bad that if we could weaponize it, we’d probably be dropping it on ISIS right now. In this article we’ll explore what Plantar Fasciitis is, what causes it, and some things you can do to get rid of it if you have it, or keep from getting it if you don’t.
What is Plantar Fasciitis?
The Plantar Fascia is a thick band of tissue that runs along the bottom of the foot and connects the heel bone to the toes. I’ve talked about fascia in previous articles, and this fascia tissue is no different. It is susceptible to becoming inflamed and you need to give it regular maintenance to work out the adhesions and keep it pliable. The Plantar Fascia absorbs a lot of abuse as the entire weight of your body is stressing it with every move you make. If you have intense and chronic heel pain, especially if your foot feels excessively sore when you first try to walk after getting out of bed or when standing up after sitting for a while, you could have Plantar Fasciitis. PF is not something you get from a single intense or long run, rather it is a condition you develop over time.
Now as with everything in the body, everything is connected to something else. On the other end of the heel is the Achilles tendon, calf muscles, IT band, hamstrings, glutes, and quads. While those systems may seem distant from the foot, if you have weakness, tightness, or lack of mobility in any of those areas, they can affect the foot and can contribute to development of Plantar Fasciitis.
What causes Plantar Fasciitis?
Bad form while walking or running is a big culprit. Heel striking is especially damaging to the Plantar Fascia. Also, if you tend to pronate when you walk or run, which is when your foot rolls inward causing the arch to flatten out, that can lead to PF issues.
Another contributor to Plantar Fasciitis problems is footwear. Now, I’ve read conflicting information as to whether a minimalist shoe with little cushioning is better or getting a more “squishy” shoe and/or one with some arch support is better. The thought with the minimalist shoe is the lack of cushion will cause you to strengthen the foot since the shoe isn’t doing the work for you. The thinking with the support insert or shock-absorbing shoe is the construction of the shoe or insert is taking some of the pressure off the tender areas of the foot. I’m no doctor and I’m not qualified to make a ruling on which approach holds more merit. I’ll just say if you have Plantar Fasciitis, consider changing your shoes (and this applies to what you wear outside the Box as well).
Do I have Plantar Fasciitis?
Before you start a treatment program, you need to determine if you really do have Plantar Fasciitis. This likely means visiting a foot specialist, as not all foot pain is caused by Plantar Fasciitis. One test you can do is to try walking up on the tips of your toes. If this feels better, you may actually have a stress fracture of the heel or a bone spur since the Plantar Fascia is elongated when the toes are loaded and rebounding, and this position puts a lot of stress on the Fascia, and it should hurt if you have PF.
How do I treat Plantar Fasciitis?
If you are diagnosed with Plantar Fasciitis, figure out what is causing your issue and stop doing it. That could mean taking some time off from running and using the rower instead. This doesn’t mean short runs are ok. It means NO RUNNING! You need to give your feet time to heal. If you are runner or frequently experience foot pain after running, consider having someone video your running stance. If you are a heel striker, learn the Pose Method and adjust your stance so you lean into your run and land on the forefoot rather than the heel. If you are loud runner, stop stomping your feet down and land softly instead.
Taking time off from running is only part of the recovery equation. You need to do some mobility on the foot and surrounding areas. Roll and stretch out the foot. Start with the least tender areas and gradually increase pressure and move to the more painful ones. This chart shows some stretches to try.
Take a look at these videos for more explanation and some other mobility ideas.
In addition to rolling out, weighted calve raises will help strengthen your calves and may help take some pressure off your Plantar Fascia if this is an area of weakness in your legs. Remember that this mobility and strength work is not a one-time prescription. It needs to become your daily routine if you seriously want to recover from Plantar Fasciitis.
If doing mobility on your own isn’t producing the results you’re looking for, seek out a therapist who specializes in ART, or Active Release Technique. This is a more aggressive form of therapy that involves manual manipulation of the affected area and gradually increasing assisted stretching that has shown to be effective in treating many deficiencies of the body to include treatment of PF.
Dr. Josh Axe recommends taking 500mg of Magnesium before bed and vitamin B5 and fish oil to help relax the fascia and decrease the swelling through improved blood flow. Again, I’m not a doctor or nutritionist. You can research this for yourself or talk to a healthcare professional to see if taking these supplements is right for you.
It is said that treatment for Plantar Fasciitis starts in bed. If you sleep with excessively tight sheets at the foot of the bed, this can cause PF issues. Tight sheets can hold your foot in a position of Plantar Flexion, which is the position you would be in if you stood on the tips of your toes. In time, this causes a shortening of the fascia, which further stresses the area when you go to extend it, such as when getting out of bed. Given that we spend up to a third of our lives in bed, time in this position really adds up.
Your doctor may prescribe a night splint that will hold your foot in a neutral position while you sleep. This allows the foot to heal naturally. Know that this is not a quick method, and depending on the severity of your condition, you may need to use this splint for 6-12 months.
The final option is surgery. You don’t want this. It involves cutting the fascia to allow it to lengthen. It can cause permanent nerve damage and the foot will likely never be as stable as it was before surgery since the procedure is weakening the very structure that ties in major parts of the foot. The surgery may also fail to correct the pain. If not cut in the right area, you may heal, but still experience the same pain. And as if you needed another reason to avoid going under the knife, the recovery time is 6-10 weeks until you can walk without assistance and up to three months more before you can resume normal activity. Fortunately, 95% of those who have Plantar Fasciitis respond to non-surgical treatments.
In the movie Karate Kid, Mr. Miyagi tells Daniel “Best defense, no be there.” Well, the best way to keep from experiencing Plantar Fasciitis pain is not to develop it in the first place. Don’t ignore the small aches and pains because they will turn into big ones. Your body is trying to tell you something. Whether you have PF or not, don’t neglect the other areas of the body that tie into the foot. Roll out and stretch and strengthen the foot and the areas that connect to the foot. Whatever you decide to do, stop heel striking. And keep an eye out for my Plantar Fasciitis rocket launcher, coming to Kickstarter soon.