One of the most common complaints of pain in runners is foot pain. The feet carry the entire bodyweight while we are logging miles so it makes sense that they are the most impacted body part. There are several injuries and causes of foot pain experienced by runners such as heel spurs, neuromas, stress fractures, and the most common issue—plantar fasciitis. This condition is also pretty common in the general population and is tough to manage, as we have no choice but to use our feet for walking. There are many causes of plantar fasciitis as well as many ways to manage this frustrating diagnosis.
The plantar fascia is a thick ligament on the bottom of the foot that runs from the heel to the toes. The role of this ligament is to support the arch of the foot as well as all of the tendons that control the motions of the toes and ankles. When the plantar fascia gets chronically overstretched tiny tears and inflammation develop which lead to the sharp heel pain and tightness experienced by those affected. When not addressed, this condition can cause other problems such as muscle strains and heel spurs which in turn worsen the foot pain and results in a more debilitating issue. Since the feet are required for a large portion of our days, it is important to take care of the issue as soon as possible.
Causes & Symptoms
Runners are prone to plantar fasciitis as they are constantly overstretching the ligaments and applying pressure to the area. People who are standing for most of their day for work such as nurses, cashiers, and waiters at restaurants are also at risk for developing this painful condition. Those affected will usually experience sharp pain first thing in the morning upon getting out of bed or after sitting for long periods of time. This is due to the prolonged position of the foot in plantarflexion (toes pointing downwards), which is when the plantar fascia is in a shortened position.
On standing and walking, the ligament gets stretched out from that shortened position, which is already inflamed and tight, and therefore causes pain. Most people will have relief of pain after walking around for a few minutes as the tightness is released. This is why this condition becomes a chronic problem. Runners usually will not have pain while running since the ligament has already been stretched out and is pain-free during activity. What runners will not know, or possibly ignore, is that the ligament is already in a damaged state and the constant running is only causing more tears and inflammation.
There are many treatment strategies for plantar fasciitis. Seeing a physical therapist for the most involved approaches is best, but there are many home remedies for runners. The first and most obvious approach is rest. Of course you cannot avoid walking around in general, but you should take a break from running for at least a few days or weeks, depending on the severity of the injury. Since inflammation is a big cause of the pain, applying ice daily, especially after aggravating activities, will help control the swelling of the ligament. Physical therapists use a technique called dry needling to manage the pain and swelling as well. This is similar to acupuncture but involves the puncturing of the affected tissue, which induces minor bleeding and recruits blood cells to begin a healing process for the fascia. Many patients have experienced long term relief of plantar fasciitis with dry needling.
As part of treatment as well as prevention, flexibility and strengthening exercises should also be incorporated. Direct stretching of the fascia by manually pulling the toes back or standing with pressure through the toes is ideal for loosing up the tightness. Strengthening the muscles of the toes is important as these are the muscles that run along the same path as the plantar fascia. A good exercise is to lay a towel on the floor and try to lift it by curling the toes for a few repetitions. Ankle strengthening can be performed easily by using resistance bands as shown below.
Keeping the foot and ankle muscles strong will eventually take pressure away from the plantar fascia so that it does not become overused and cause inflammation. Runners should incorporate these exercises a few times per week, as well as stretch daily after runs to keep the fascia healthy. It is important to always monitor pain and take time off of aggravating activities in order to avoid developing any chronic issues that will leave you out of running for a long period of time. Wearing proper shoes for your foot type is also important, as well as gradually increasing mileage during training. As with any other condition, you should seek advice from a medical professional if symptoms persist.