Plantar Fasciitis
Although broken bones and sprained ankles may be what one thinks of as a debilitating force for athletes, a runner's kryptonite can be something as insignificant as plantar fasciitis, leaving discomfort with every step taken. Also known as policeman’s foot, this small but mighty syndrome leaves many athletes alike; old or young, amateur or professional, fast or slow; with an internal battle to be faced each day. Let’s explore this infamous condition together.
What is it?
Due to the nature of athletes' intense regimen, many individuals, specifically runners, suffer from plantar fasciitis, one of the most frequently occurring hindfoot problems. Plantar fasciitis is the inflammation of the plantar fascia attachment, a band of tissues that runs across the heel bone to the base of the toes and plays a major role in foot health, supporting the arch and connecting the bones within the foot. It is made up of three primary components, the medial, central, and lateral; with the central being the largest and most prominent. According to the Cleveland Clinic's article on Plantar Fasciitis, "Around 1 in 10 people will develop plantar fasciitis at some point throughout their life."
Causes:
Through overuse, the tension placed in the plantar fascia from walking, running, jumping, pounding, etc. makes it irritated, losing its elasticity. The micro tears that follow as a result create pain.
Specific risk factors include:
Constant exercise
Age (40-60)
Increased weight, Obesity
Type of shoes and its support
Activity on hard surfaces
Foot mechanics and structure
Symptoms:
Pain is usually described as either a sharp or dull ache along the bottom of the foot. It is typically at its worst after periods of inactivity; the degree of discomfort will generally decrease as it warms up, though too much vigorous activity will make it worse right after. It may be more intense barefoot or with low-support shoes.
Diagnosis:
Plantar fasciitis is diagnosed based on medical history and a physical exam provided by a healthcare provider. Imaging tests such as x-rays, ultrasounds, or MRIs are usually not used to diagnose the condition but rather used to confirm or deny other possible problems. They will question symptoms, intensities, and daily routines, as well as check areas of tenderness to measure inflammation and level of pain.
Treatment:
Depending on how long symptoms have been present, as well as their severity, different treatment and recovery plans may be used, including:
Physical Therapy/Stretching - Exercises and stretches that target the plantar fascia, Achilles tendon, and lower leg muscles can allow for stabilization and release of tension.
Icing/Medication - Taking over-the-counter NSAIDs (aspirin, ibuprofen, naproxen) or icing for 10-15 minutes can aid with inflammation and pain management, which will help speed up the healing process.
Orthotics - Shoe inserts can provide additional support to the arch and distribute pressure more evenly. Providers may suggest pre-made or custom-made to your foot.
Rest - Decreasing distance or duration of aggravating activities will allow the foot ample time to heal, instead of constantly suffering the effects of overuse.
Shockwave Therapy - Low or high-energy shock waves may be delivered to a specific area, stimulating healing by creating microscopic trauma. This is used for more chronic cases.
Surgery - If more conservative treatments still render useless, surgery may be used, though it is rare. The two main types are gastrocnemius recession, which lengthens the gastroc tendon– known to be connected to tension in the plantar fascia–to release pressure. The other is the plantar fascial release, where small incisions are made to detach parts of the plantar fascia from the bone, relieving extra tension.
Prevention:
To prevent plantar fasciitis, it is most effective to take good care of your feet by stretching, investing in supportive shoes, and allowing rest after intense activity. Some beneficial stretches include:
1. Golf Ball Stretch
2. Dorsiflexion of Toe Stretch
3. Wall Lean Stretch
Sources:
“Plantar Fasciitis.” Hopkinsmedicine.org, 8 Aug. 2021, www.hopkinsmedicine.org/health/conditions-and-diseases/plantar-fasciitis#:~:text=Plantar%20fasciitis%20is%20the%20inflammation,plantar%20fasciitis%20is%20heel%20pain. Accessed 9 Dec. 2023.
Clinic, Cleveland. “Plantar Fasciitis: Symptoms, Causes & Treatment Options.” Cleveland Clinic, 2022, my.clevelandclinic.org/health/diseases/14709-plantar-fasciitis. Accessed 9 Dec. 2023.
“Plantar Fasciitis - Symptoms and Causes.” Mayo Clinic, 7 Sept. 2023, https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846. Accessed 9 Dec. 2023.
Middleton, J. A., and E. L. Kolodin. “Plantar Fasciitis-Heel Pain in Athletes.” Journal of Athletic Training, vol. 27, no. 1, 1992, pp. 70–75.