As an avid runner, I have a passion for helping fellow runners and athletes get over injuries, avoid injury and feel their best. One common injury I see is Plantar fasciitis. This is an overuse injury effecting the large tendon on the bottom of the foot.
When this area is repetitively over stretched, microtears develop causing inflammation & pain typically where the tendon attaches to the heel bone(calcaneus). This pain is usually worse in the morning and sharp when first starting to walk.
This condition can be quite bothersome and long lasting if not properly addressed. It can last for weeks to months and can often become chronic. That’s why it is important to find out why this happened to you and correct it. Below are a few ways the heel can be overworked leading to tendon damage and pain
Overpronation- If the medial arch is collapsing this can cause the foot to flatten and roll inward. This puts added strain on the muscles of the foot & tibialis posterior muscle causing micro tears to the tissues. Some pronation is normal but excessive pronation and time is a recipe for injury.
Tight/weak calf muscles-Chronic calf tightness puts stress on the Achilles tendon and heel. Weak calf muscles will cause other muscles to pick up the slack.
Weak hip muscles can cause us to favor one side of the body over the other. This can lead to the foot on the stronger side dealing with more of the workload and can cause injury.
Spine and pelvic misalignments. If the joints of the body are not moving properly this can change how we walk, run and sit. Eventually there is a point where the body can no longer deal with the imbalances and starts to breakdown.
Ankle and foot misalignments. Without proper ankle motion, the foot will eventually become injured.
Improperly fitted, worn down or shoes with little support.
Drastic changes in athletic training.
Changes in work duties that put us on our feet more.
Things you can do yourself to help: (if the pain is too great, consult your doctor first before performing any at home routine)
Consider your footwear. The correct shoe can help support the foot and reduce additional tendon damage. The wrong shoe can make it worse. Running specialty stores can give a lot of insight on what will be best for you. And many stores carry shoe inserts that will help support the arches of the feet.
Do not walk barefoot. At least until the issue is resolved. The foot will flatten, and you are likely to injure it more. Especially first thing upon waking and taking those first steps you can irritate the tendon losing much of the healing that was occurring while sleeping. Try having a supportive sandal to slip into first thing when you get up to help prevent this. Until the tendon is healed, the arches need to be supported.
Gently massaging the arch of the foot using a frozen water bottle, lacrosse ball, golf ball, etc. will help to loosen up the area and increase blood flow to the tissues. Do this several times a day for 1-2 minutes at a time.
Stretch the calves (bent & straight knee). Hold the stretch for 5 seconds and repeat 10x. For both feet. Do this 2x per day.
Strengthen the calves (bent & straight knee). Many times, a complicating factor is weak calves. Do 2 sets of 10 repetitions of this exercise 3x per week. Perform one leg at a time. I prefer doing this off the lowest step in the house. Lower the heel slowly down past the step. Pause, and then raise up past the step 2 inches. Pause, and repeat. DO this in a range that doesn't reproduce the pain. Reps are dependent on where you are at. If 10 is too many do 5 and work up to 10. If 10 is too easy do 15 reps.
Strengthen your arches. Place a small towel on the ground and try to pick it up with your toes. Pause, and release the towel. Do 2 sets of 10-15 repetitions. Perform this exercise daily.
Strengthen the hips. Weak hips are a major contributor to most running injuries. A few options are the clamshell, side lying abduction, lateral walk using resistance bands & my personal favorite in the video below.
Stretch the Hamstrings. These muscles flex the knee and extend the hip. When tight they can cause back pain, knee pain and can affect sport performance. Check out the video for my favorite way to stretch the hamstrings
Epsom salt soak. 10 minute soak daily in warm water. This will help improve blood flow and relax the area. I typically use a cup of salt per gallon of water.
It is a great idea to get the feet and spine evaluated for any biomechanical issues. As a chiropractor, I understand the importance of evaluating the feet. They are the foundation of the spine. Problems here can affect everything up the kinetic chain. Restoring normal joint motion will aid in recovery and help with injury prevention. Checking the hips and spine is vital to overall health and sport performance. If the spine & joints of the feet are out of alignment, our nervous system cannot function properly and injury may follow.
Treatments I offer that can help:
Foot and spinal adjustments. To properly heal, the joints of the body need to be moving and functioning properly. Adjustments help restore proper joint motion.
IASTM(instrument assisted soft tissue mobilization). These tools aid in breaking up adhesions and scar tissue that can develop in the foot. Once the scar tissue is removed, healthy tissue can take its place.
Corrective exercises. Performed once the spine and feet are in proper alignment. Or performed in tandem. I can design a program. But if you are that individual that needs 1 on 1 attention, then a physical therapist should be incorporated in treatment.
When searching out a professional for help with any overuse injuries, make sure they have these treatment goals:
Address any damaged and injured tissue that affects motion and causes pain
Address any joint dysfunction in the area of complaint and any areas related to it.
Prescribe corrective exercises
Address shoes and any other daily activities that might adversely affect the injury
Willing to work with other professionals on what is best for the patient.