Plantar Fasciitis Treatment
Everyone who has experienced plantar fasciitis understands how frustrating and annoying it can be.
-heel pain or a cramping sensation during running and jumping that just won’t go away
-getting out of bed in the morning and for the first few steps having to hobble due to the sharp discomfort in the bottom of the foot
-running with the sensation of a pebble in the heel and having feet that are super sensitive
Issues with the plantar fascia are common for runners, dancers, and athletes that require jumping in their sport. It can be due to a variety of factors, which we will break down in this article. First we will touch on what the plantar fascia is, how to know if the issue is coming from this structure, what causes issues, and what a rehab plan may look like to get rid of the pain for good. The goal of this article is to let you know that there is HOPE. Plantar fasciitis can be very frustrating but with the right guidance and plan, it is something that can be overcome and fixed!
What is the plantar fascia?
It is NOT a muscle, rather it is an aponeorosis, which is a wide flat tissue that connects from your heel bone to your toes. It works like a pulley; when your toes are extended, like when you are pushing off in running and walking, the plantar fascia is pulled taut from the heel and allows your middle arch to rise. This works together with the muscles within the foot to support the arches and feel the ground as you move.
The most classic characteristics of plantar fascia issues are morning pain with the first few steps out of bed, pain that gets better with activity but recurs with fatigue during longer runs or jumping activities, and pain near or at the front of the heel bone. There are other things to rule out including calcaneal stress fracture, tendinopathy, or nerve conditions of the foot. Not everyone’s pain is the same, and everyone’s anatomy is different, so to rule in/out the right conditions be sure to see a healthcare professional who understands your sport that you can trust.
Who gets it and why?
Many runners will suffer from some plantar fascia or foot pain with running during their time in the sport. In the literature, some common underlying factors that can put one at an increased risk for developing plantar fasciitis are:
-change in exercise variables (training volume, running surface etc)
-Limited ankle dorsiflexion range of motion
-Weaker intrinsic foot muscles
-Obesity
Temporary Short Term Relief vs. Long Term Solutions
Short term relief:
-If you have been experiencing these symptoms that limit your running minutes, limit your speed, and prolong your time getting out of bed due to fear of those first few steps, there is a chance that you have already tried some things such as icing, stretching, rolling your foot around with a lacrosse or golf ball, scraping/GRASTON, or even orthotics. While these things may provide short term relief, the majority of times this relief is temporary and the pain typically comes back once the athlete tries to reintroduce some more impact plyometric activities such as running or jumping.
Long Term Solutions
-In order for the plantar fascia to be able to tolerate all higher impact movements, we need to find tolerable ways to improve the overall CAPACITY and STRENGTH of the plantar fascia and overall foot. By sitting down with a Performance PT to make a plan to improve the resiliency of the plantar fascia and foot/ankle complex, you are more likely to have a shorter recovery time and get back to running, jumping, and dancing pain free much quicker.!
What can a performance physical therapist do for this?
Rehab for PF will likely include a plan that your PT and you will come up together that progressively gets you back to the activities you love pain free! These things can include
Determining triggers for increased sensitivity and finding a way to manage those stressors.
Understanding tolerable pain vs. bad pain vs. good pain an what level of discomfort is okay to push into.
Finding a tolerable entry point of loading for the plantar fascia and calf complex. Strengthening exercises such as calf raise variations will be a staple!
Understanding the perfect dosage by monitoring discomfort levels after loading the tissue 48-72hrs.
Mobility for all ankle directions: working on dorsiflexion, plantarflexion, and inversion/eversion if limited
Short foot exercises: working on the muscles that are intrinsic to the foot and do not attach above the ankle, including small arch and toe muscles that are often overlooked
A progressive return to running program that slowly increases your running mileage pain free until you’re back to a regular training regime!
If you’re tired of dealing with heel and foot pain, reach out to us today to schedule an appointment, and get back to running and jumping pain free!