Plantar Fasciitis Treatment for Runners
Did you wake up one morning and your foot was in so much pain when it hit the ground that you looked around for your missing Lego pieces from childhood? Yeah, you know exactly what I’m talking about. The pain that shoots right up your foot into your heel that makes you want to jump right back into bed?
Welcome to the plantar fasciitis club! Plantar fasciitis is an irritating inflammation of the band of tissue under your heel and it can be more annoying than your little brother (sorry Dave!)
So you’ve done your research and rolled your foot over a frozen water bottle 100 times but you still don’t feel better?
Keep reading this blog post to learn more about plantar fasciitis and how to effectively treat it to get back to running again.
What is Plantar Fasciitis?
Plantar fasciitis is a painful condition that affects the plantar fascia, a thick band of connective tissue that runs along the bottom of the foot. The plantar fascia connects the heel bone to the toes. It acts as a shock absorber and supports the arch of the foot.
When this connective tissue is inflamed, it can be excruciating and is often diagnosed as plantar fasciitis. The pain from plantar fasciitis is usually felt on the bottom of the heel or along the arch. It results from small tears and inflammation in the plantar fascia, often due to repeated micro-trauma or overuse.
Your plantar fascia provides what is called the “windlass mechanism”. This allows the tissue to “wind up” and shorten when you are pushing off your toes as you step forward. The windlass mechanism provides support to your arch.
For runners, this mechanism is crucial. It acts to support and maintain the arch. It also creates an efficient push-off each step as you run.
What causes Foot Pain?
There are a few reasons why Runner’s are prone to plantar fasciitis.
1. Calf Tightness
Calf tightness can decrease ankle dorsiflexion (the ability to bring your toes towards your shin). While you are running your ankle needs to dorsiflex to move forwards. When you have decreased movement in your ankle due to calf tightness, your body will try to find this movement from somewhere else. This can increase stress on your plantar fascia, resulting in inflammation and pain.
2. Decreased Movement of the Big Toe
Your big toe is a big deal! Restricted movement in the big toe can disrupt the windlass mechanism discussed earlier. If your big toe does not have enough movement, it puts more tension on the plantar fascia. This is especially problematic when you are pushing your toe off the ground to take your next step.
3. A sudden increase in Training
A rapid increase in your mileage, speed, or running surface is a recipe for injury. Your body needs time to adjust to the repetitive ground forces. If your plantar fascia is not strong enough to respond to this stress, it often results in inflammation and pain.
4. Decreased calf and foot strength
Your feet and calves need to be strong as a runner! (Yes you have muscles in your feet). These small intrinsic muscles stabilize the bones in your foot and you hit the ground. If these muscles are weak, the plantar fascia has to absorb more force.
What is the best Plantar Fasciitis Treatment for Runners?
It is important to get a proper medical diagnosis and treatment for any condition. The information provided below is very high-level recommendations. Every person and injury is different and we recommend consulting with your medical providers as this is not medical advice.
1: Reduce Inflammation: Modify Activity/Taping/Bracing/Modalities
Step number 1 is to reduce inflammation in the area. Avoid the activities that are causing you pain as best you can. Since pain is often worse in the morning, we recommend using a plantar fascia night split. This night splint stretches out the tissue to allow proper mobility when walking. If you experience a lot of pain first thing in the morning, try placing a pair of slippers or supportive flip flops (I love oofos) next to your bed. You can also try taping your arch to give your foot more support.
2: Improve soft tissue quality
To reduce the symptoms of plantar fasciitis, it is important to mobilize the surrounding tissues. This includes the calf and bottom of the foot. Many people receive the advice to roll a frozen water bottle under their foot. This is effective as a temporary fix.
We recommend using a lacrosse or baseball under the foot and calf to improve the soft tissue quality.
Another great way to reduce inflammation is vibration. Percussive therapy (massage guns), provides temporary improvements in muscle flexibility. Here are some expert recommendations for using a massage gun.
- Pressure: Apply moderate pressure but not to the point of pain or discomfort. We also recommend avoiding the heel or going over the bone. Massage guns work best over soft tissue.
- Duration: 2-3 minutes is plenty. Don’t overdo it! Too much of a good thing can result in more damage to the tissue.
- Technique: Be cautious using a massage gun directly on the painful heel area during an acute flare-up. This can further aggravate the condition. Aim for circular motions over the calf muscle and bottom of the foot in between your toe and heel.
- Timing: Best to use before stretching and strengthening to improve ankle mobility and strength
3: Address Mobility Impairments
If you failed the ankle mobility test above (here it is again), we have some suggestions! Here are 2 stretches to try to improve your ankle range of motion:
- Foot Elevated Ankle Stretch (Forward/Circles)
- Standing Calf Stretch with Toe Elevated
Strengthen
This is the area that most people skip when rehabilitating from a plantar fascia injury! Adequate strength of your intrinsic foot muscles, calf, and hips are essential to returning to run. Here are 3 exercises that can strengthen these areas:
- Toe Yoga
- Eccentric Heel Raises
- Lunges with a Heel Float
How to Return to Running after plantar fasciitis
Now here’s the good stuff! How do you return to running after a plantar fascia injury? Here are some recommendations:
- Proper warm-up and cool-down routines.
- Choosing supportive and well-fitting shoes.
- Gradually increasing training intensity.
- Maintaining good cross training program
The return to running comes a lot slower than we all would like. It can be frustrating, but building consistency over time is the most effective way to return to the sport you love (or love to hate).
Wrapping up on Plantar Fasciitis Treatment for Runners
Plantar fasciitis can be a frustrating injury to deal with but remember – slow and steady can win this race. With the right approach, you’ll be back on track.
Here’s a recap on the steps to take:
- Decrease inflammation
- Improve Flexibility
- Build Strength
- Don’t rush your return to run
At In Motion Physical Therapy, we get it. We’ve been in your running shoes, and we know the itch to get back to your training plan. That’s why we’re here to provide that one-on-one care to keep you in motion.
If you’re still struggling or want personalized guidance, click here to get in touch. Let’s work together to get you back to running again!
Now, who’s ready for a run? (After proper warm-up, of course!)
Sources:
Sams L, Langdown BL, Simons J, Vseteckova J. The Effect Of Percussive Therapy On Musculoskeletal Performance And Experiences Of Pain: A Systematic Literature Review. Int J Sports Phys Ther. 2023 Apr 1;18(2):309-327. doi: 10.26603/001c.73795. PMID: 37020441; PMCID: PMC10069390.
Lakhwani, M., Vakharia, P., Sawant, N., & Lathi, S. (2022). Efficacy of Percussive Massage versus Calf Stretching on Pain, Range of Motion, Muscle Strength and Functional Outcomes in Patients with Plantar Fasciitis – A Research Protocol. Research Square. https://doi.org/10.21203/rs.3.rs-1569347/v1
Martin, J. (2021, January 20). A critical evaluation of percussion massage gun devices as a rehabilitation tool focusing on lower limb mobility: A literature review. https://doi.org/10.31236/osf.io/j9ya8
