Running Injury Spotlight: Plantar Fasciitis

The Friday before New Years I went out for a training run. Within half a mile the back of my heel started to hurt. I have never had a running injury before but the first thing that came into mind was a running injury. I ignored it for that run but then my feet were hurting bad enough to not run the next day. Then on New Year's day I went on a nice run and ignored my hurting heels hoping it would be fine but then that night my heels felt really strange, painful, and swollen - so much so that it was difficult to sleep. So I started reading about run injuries and my symptoms quickly matched DA-DA-DUM, you've got it: plantar fasciitis. Plantar fasciitis is one of the most common complaints related to the foot and mostly affects men between the ages of 40 and 70. It occurs in 2 million Americans a year and 10% of the US population over a lifetime. I feel like SUCH a statistic, except for the man part. 

Plantar fasciitis is an inflammation of the thick tissue on the bottom of the foot, called the plantar fascia, and this connects the heel bone to the toes creating the arch of the foot. This can occur when the fascia are overused or overstretched. Many things can be a culprit including: 

1. Foot arch problems (flat feet or high arches)

2. Poorly fitting shoes including shoes with poor arch support or soft soles

3. long distance running - particularly down hill or on uneven surfaces

4. Tight calves (tight achilles tendon which attaches the calf muscle to the heel)

5. Sudden weight gain

Well, I realize it was the holidays and I was feeling a bit like Santa running after all of the holiday cookies and beer, but I'm pretty sure #5 was not the culprit. I also really don't think it was my running shoes that caused this but I sure did wear those cute flat knee high black boots around Christmas time ALOT. I was in them way more than my tennis shoes around the holidays. And yes, it seems like they made my feet hurt, but they were cute and isn't that how it always is with cute girly shoes? So, sadly I have ditched the cute knee high boots and replaced them with cute black boots with more support. Sigh. 

Ah, Goodbye cute knee highs worn through the holidays!

The symptoms include sore heels and it is particularly painful on that first step in the morning and quite painful to walk. Right now I wouldn't be able to run into T1 barefoot that is for sure! I have spoken with many people who have suffered from this. Some recovered within two weeks while some took 8 months and still don't feel completely better. Apparently most people feel better within 9 months. Gheez, plantar fasciitis is like having a baby? 

The remedy includes:

1. Heel and foot stretching exercises: (See this website for descriptions: 

http://www.heel-that pain.com/plantar_fasciitis/exercise/plantar_fasciitis_exercise.php)

a)      Towel curls.  Barefoot, sitting on a chair on a hard surface floor.  Lay a towel out in front of you and place your toes on the towel…heel on the floor.  Use your toes to scrunch up the towel, bringing the far end closer to you.  Keep your heel in place and lift your foot slightly as you scrunch the toes bringing the towel toward you.  Add some wt. (shoes, cans of food, etc.) to the end of the towel for extra resistance.  Maybe 5-8 sets of this…2-3 x per day.  Obviously any real pain…stop, stretch, ice.

b)      ABC’s.  Barefooted…in the air, draw out the abc’s with your big toe.  Make the motions deliberate and controlled.  The more pain free motion the better.  Go through the complete alphabet 1-2 x…2-3 x per day.  This will help keep your muscles working and give you some stretching in the ankle/foot complex.

2. Stretching the calf muscles (you can do this with a foam roller) to reduce the pressure on the fascia
3. Warming up your heels before your run by rolling a tennis ball on your heel and you can follow up afterwards with this as well
4. Night Splints to sleep in (special socks designed to stretch the fascia)

5. Resting as much as possible for a week (like this could ever happen for anyone in REAL life)

6. Wearing supportive shoes (gheez, feeling my age now)

7. Icing 10-15 minutes twice day

And if this doesn't work:

8. Wearing a boot cast for 3-6 weeks (now that would look cute - NOT)

9. Custom made shoe inserts

10. Steroid shots or injections in the heel
11. Platelet rich plasma - injections of your platelets from your blood directly into the fascia (It takes so long to heel because the fascia do not have a blood supply and this may speed up the healing process)

So, I have continued running but finally gave in this week and realized I need to deal with this pain and let it get better. That means water running in the pool for me! More to come! Yay!