Ever get a sharp pain on the bottom of your foot? Do you dread getting out of bed because you know that as soon as you take your first step, the pain will make you wish you were still under the covers? This may be due to a condition called plantar fascitis.
Plantar fascitis is the inflammation and microtearing of the plantar fascia. The plantar fascia is the connective tissue on the bottom of your foot. This is an overuse injury that is caused by repetitively overloading the tissue. This can be seen in someone starting a new running or walking program. A sudden increase in mileage on a hard surface may also be a cause. People with high arches and those that overpronate (foot rolls inward) when running may be at higher risk to suffer from this.
This condition is characterized by pain on the bottom of the foot, usually near or at the heel, with weight bearing. The pain is most often greatest in the morning when you take your first steps out of bed, and is aggravated by walking, running or jumping. As the condition progresses, every step may be painful. Over time this may cause a heel spur.
Rest and ice are important first steps in the treatment of plantar fascitis. Do not forget that this is an overuse injury. It is crucial to remember that continuing to train through pain can cause further damage and delay healing. The plantar fascia must have time to heal by resting the area and not causing continued inflammation. An ice cup massage or an ice pack, is a great way to help reduce the inflammation. Stretching of the calf muscles (gastrocnemius and soleus) along with the plantar fascia is extremely important as well.
Other options to consider are finding appropriate shoes with arch support, or shock absorbing insoles. Custom orthotics may be beneficial if there are structural problems in the feet. More serious cases may require a resting night splint that is worn during sleep to help stretch the plantar fascia. Although many find that the splint is uncomfortable and difficult to sleep in, good results are usually achieved if it is used as prescribed.
Once the pain and inflammation are down, the area needs to be strengthened in order to prevent the condition from returning. Any weakness in the calf or thigh needs to be addressed and corrected before returning to running or sporting event.
If you are bothered by heel or foot pain, and it is interfering with your training or daily routine, please give us a call or come by the clinic for more information. Physical therapy can get you started on the road to recovery.
References: 1. Cunninham, C. & Bourazak, L. (1999) Clinical Exercise Specialist Manual: American Council on Exercise. Musculoskeletal Challenges. San Diego, CA. 2. Bahr, R. & Maehlum, S. (2004) Clinical Guide to Sports Injuries. Gazette bok, Oslo.