Running is a physical and mental journey that is often full of enjoyment, but also can quite literally have a few bumps in the road as we train harder. Runners are notorious for running through pain and injury. I understand that it can be frustrating as it is for any athlete to have setbacks or be forced to discontinue what we love to do. I myself am running a half marathon next month that if I am being entirely honest with you, do not feel 100% ready for.
One of the most common conditions that runners try to fight through is Plantar Fasciitis. Whether you are an ultra-marathon runner or trying to get more active for your new year's resolution, it is important to understand this condition as it is the most common cause of heel and foot pain.
Plantar fasciitis affects the arch of the foot where there is a thick fibrous band called the plantar fascia that connects to the calcaneal (heel bone). This terminology indicates acute inflammation but can also originate from non-inflammatory chronic degeneration. For example, runners who are new to running or have a drastic increase in mileage can experience this pain or the experienced runner that previously experienced the initial inflammatory response and then the tissue did not heal properly causing the pain to worsen.
Factors that are important to consider are getting the right diagnosis and looking at biomechanical deficits that could be making the condition worse. An evaluation that takes gait and other possible diagnoses into the equation can be crucial to evaluating and treating this with better long-term outcomes. People with jobs predisposed to long periods of standing like teachers, nurses, construction workers, salesmen are also at an increased risk as well. One unique fact I love is that patients are up to 9x more likely to have hamstring tightness if they have plantar fasciitis, meaning it is important to assess if other areas are contributing to the dysfunction. Other biomechanical deficits include hip mobility issues, ankle instability, and foot weakness.
The most effective conservative treatments include shock wave therapy, myofascial techniques including IASTM, mobilization or manipulation of the ankle, stretching of the various affected structures, and strengthening of intrinsic foot musculature and calf complex. Some of the best things to do at home include using a lacrosse ball to perform self-myofascial release of the foot and calf, eccentric calf raises, towel crunches, and using toe spaces to help spread out the toes. At Strength & Spine, we love the fasciitis fighter, ToePro, and MOBO boards to help with conditions like this. All these tools are geared towards strengthening the foot and ankle muscles. After using these, you’ll feel muscles in your feet you’ve probably never felt before.
Now the question I know you care most about….How much can I run now and how do I continue to run at all? You may have to temporarily limit activities that make your symptoms worse only until you can treat the root cause of the dysfunction to return to your goals of running well and further. Considerations of decreasing stride length and having a shoe that functionally supports you should be discussed with your provider. The best piece of advice I can offer is to find a level of running that is tolerable and then increase your mileage by no more than 10% until symptoms resolve.
If you have questions, your pain continues to persist, or you want guidance along your running journey, you can schedule an appointment online at strengthchiro.com or call us at 727-228-3030.
Dr. Caleb Hebert DC