Managing and Preventing Plantar Fasciitis

Plantar fasciitis is one of the five most common running injuries alongside PFPS (Runner's Knee), IT Band Pain Syndrome (ITBS), Achilles tendinosis and tibial bone strains (a class of injuries that includes shin splints among its symptoms). Because running is classified as a sport with high risk injury with some estimates saying up to 60% of runners get injured, chances are you or a runner you know has had at least one of these issues.

Today our focus is on plantar fasciitis, which like the other four are not a death sentence. All five are essentially overuse injuries that can be prevented with smart training, proper technique, and other good habits. ​

So what is it?

Plantar fasciitis is the inflammation and pain felt by the plantar fascia. 

The plantar fascia is a network of connective tissue along the underside of the foot. With each step we take while running, two to four times the force of your body weight is sent through the feet and on up the rest of the body. Fascia in the foot and throughout the body exist in part to distribute forces smoothly and safely.

The plantar fascia stretches and retracts as the foot flattens and rolls to meet the ground and then push off. Over time, the plantar fascia can accumulate damage and we may begin to feel pain in the underside of our feet.

What can we do about it?

Like any injury, your best shot is to catch it early or even better be taking preventative measures all along. Good preventative measures that can also help manage it (up to a point) are regularly stretching the toes, calves, and achilles tendon. You can find those instructions for them here as part of a post run stretch routine I created.

Massaging the feet are also helpful, which can be done with a foot wheel or foot roller. Check out my article on three great massage tools for runners to learn more about that.

Three other ways to prevent and manage plantar fasciitis (and any overuse injury) is to run less, reduce your impact and its effects, and develop more leg and hip strength. A good training program should see you increasing running gradually and backing off when presented with pain anywhere in your body. Impact can be reduced by choosing to run softer (don't take this to an extreme though) and through better running technique. Hip and leg strength can be developed through a strength routine such as this hip strengthening routine, hill sprints after runs, running in hills, and other strengthening exercises.

The above techniques are best done as either preventative measures or in the earliest stages of the injury. However, stretching, foot massage and rolling are very helpful at every point and severity level. These are best done earlier in the morning and after longer periods of sitting.

If it continues to progress to the point of severe pain or even consistent moderate discomfort while running then a break from running is needed. Cross training in low impact sports can help maintain fitness and prevent the temptation for returning too soon to running.

Cortisone injections and shock therapy are the go to treatments for plantar fasciitis if it has become a significant issue. I'd recommend going to a doctor who works with runners if you feel that course is needed.

Plantar fasciitis can take a long time to heal thanks to the necessity of being on our feet, which will challenge sufficiently damaged tissue. However, the right mix of preventative measures and wise management will lead to a recovery for most within three to six months.

That's it for today, and happy running!
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