Plantar fasciitis is one of those injuries that most people have never heard of, until they experience it themselves. Then, when in conversation with others, they discover a large fraternity of fellow sufferers.
Many people say that the pain from plantar fasciitis feels like a stone in their shoe, or a bruise under their heel. It is often mistakenly called a ‘heel spur’.
There may be injuries more common than this one, but plantar fasciitis has still claimed a huge amount of unwilling victims, leaving them bitter from the debilitation and longevity of the condition.
Our feet are crucial for transporting us around, and we often take their pain free function for granted. A change in footwear, a change in impact volume, or simply getting older, can all be triggers for plantar fasciitis. By following some simple advice, you can continue to take pain free feet for granted!
Anatomy Made Easy
There are many small bones in our feet. The many articulations allow our feet to mould to the ground underneath us, assisting our balance. These bones combine to form an arch, from our toes to our heel, which provides shock absorption when our foot hits the ground. It is the role of the plantar fascia, a strong, fibrous band of tissue, to maintain the arch, a bit like the string on the bow of a bow and arrow. As our foot hits the ground, tension is placed on the fascia. The fascia stretches, just a little, to allow the arch to compress slightly and absorb the shock. It then quickly reaches full tension, thereby resisting the impact force from flattening the arch altogether.
‘Plantar’ refers to the sole of your foot, and ‘fascia’ is name for the thick tissue that maintains the arch.
What Goes Wrong
When the foot is given too much load than it has the tolerance for, the fascia becomes overloaded. This may be from increasing walking or running volume too quickly, a change in footwear, an increase in weight, or starting a new activity.
If the fascia gets repeatedly tensioned, without having adequate time to build up it’s resilience, something has to give! The most vulnerable point in the fascia is where it attaches on to the undersurface of the heel bone (calcaneus), so this is often where problems will arise. This attachment point becomes tender and inflamed, and can be felt when you walk or jog on it.
Often sufferers report that the pain is worst first thing in the morning, as soon as they get out of bed. By staying off the fascia for hours in bed, the tissue can tighten, and the inflammation has a chance to build up. Once you get up and get moving, the pain may ease off somewhat, due to the tissue loosening up.
Some people think this condition is the result of a bone spur. In fact, if a spur is shown to be present on xray, it is usually the effect of the plantar fasciitis, rather than the cause. The presence of a spur on xray does not conclusively diagnose the reason for the pain.
Once plantar fasciitis has set in, it can take a very long time to settle down – sometimes a year. The fascia becomes very sensitive to overload from weight bearing, so even lesser impact activities stir it up. It also doesn’t respond well to excessive rest, as the tissue can become stiff. Treatment can be a precarious balancing act.
Injury Proof Toolkit
If you keep your feet and ankles strong, your weight healthy, and a degree of impact activity constantly included in your life, this is a really great start!
If you commence or change your impact load (this can even include starting walking for the first time), make sure you don’t do the activity on consecutive days to start with, and try to use the 10% rule – increase load or volume by no more than 10% each week.
The exercise included below will ensure that your Plantar fascia is kept supple.
Make sure your footwear is always well fitted and not more than 6 months old, especially if used regularly. Stores that specialize in sports shoes often have well trained staff on hand to ensure that the runner you choose is the right one for your foot – this is a great idea. Going for long walks or jogs in street shoes or flat shoes is not a great idea.
Injury Proof Toolkit:
1) Change Your Environment
- Ensure your running shoes are not more than 6 months old, and have been fitted by a reputable sports shoe store
2) Change Your Habits
- If you are starting from scratch, start gradually – this is different for everyone, but as a rule of thumb make your first few sessions about 70-80% of your max capacity.
- Increase the impact activity by no more than 10% volume each week
- Perform the new or increasing impact activity on alternate, not consecutive days, at least for the first 4 to 6 weeks
3) Add This Exercise
- Kneel on both knees
- Tuck your toes under
- Lower your bottom onto your heels. You should feel a slight stretch in your arches
- Hold for 20 seconds