December 9, 2019

Foot Pain When Running? | What Is Plantar Fasciitis & How To Treat It

– If you’ve had it, you’ll know about it. Plantar fasciitis is one of
the more painful of injuries as well as equally frustrating due to its typically slow healing time. Well, avoiding it in the first place is obviously the best scenario but if you have been unfortunate enough to pick up this injury, you’ll most certainly want to
solve it as soon as possible. So, today, I’m going to be talking about how to cure but even more importantly how to prevent this pain in your foot that is plantar fasciitis. (mysterious electronic music) (relaxing electronic music) If you’ve not had this injury you might be wondering
what all the fuss is about. Well, it’s a pain underneath your foot just in front of your heel bone where the fascia attaches to
your calcaneum, your heel bone, and sometimes you can also feel discomfort down the center of the
arch along the foot. When your plantar fascia becomes
inflamed or overstressed, it leads to discomfort, more often in the morning and after rest, and it’s important not to confuse it with bursitis of the heel pad. This is very much in front of your heel as opposed to the main ground contact point of your heel bone. Fascia is a flat band of connective tissue that connects tendons,
ligaments, and bones, and basically acts like a web
that holds the body together. Now, if you look at the foot, that’s made up of 26 different bones. So, imagine if one of those joints isn’t quite moving properly, it’s going to affect the whole
of the foot’s biomechanics while the plantar fascia itself actually holds together the
heel bone, the calcaneus, and then runs under the foot and attaches to the base of the five toes. As a result, it plays a crucial role in the movement of the
foot during heel strike, mid stance and toe-off, controlling the pronation of the arch, and therefore it helps
with shock absorption during the ground contact phase, but also with energy return when it comes to the toe-off phase. It can start as quite a subtle pain that just comes on
gradually and some people even describe it as though
they’ve stood on a pebble, but this dull ache can end up leading on to an acute pain and is especially tender and sore if you pupate the area. Now, it can be confused with a few other problems in the foot such as a bruised fat pad on
the heel pad or even bursitis, but there are a couple of
distinct signs that set it apart. The most obvious symptom that
differentiates this injury is pain in the morning when you get up or after a long time of sitting or not moving your foot and ankle, and it will gradually
decrease as the fascia gets stretched naturally from walking, but it can also increase the pain if you’re spending a long time standing, doing a lot of walking
or also during running. Now, the acute pain can
sometimes initially die down, but if you don’t actually
address the injury properly, then it can lead to chronic pain due to micro tears in the fascia. So, it is and most certainly
worth sorting it out early on because you’ll end up
being out from running for a very long time. Now, plantar fasciitis is less likely to be found in forefoot runners, but it can happen in either foot and sometimes even both,
but that’s pretty rare. There are multiple causes
to plantar fasciitis, but the most common
being a sudden increase in training intensity and or volume which is going to put a lot of strain on the connective tissue and the muscles that surround the foot and the lower leg. Also, a lot of sprinting
or plyometric exercises when your body’s not fully
prepared or warmed up can also lead to micro
tears in the fascia. Tight calves go hand in
hand with an increase in training volume and that
in turn puts more pressure on the structure of the foot. So, you could see it
as a lack of stretching being the problem or maybe an increase in training too quickly, or maybe a combination of the both. Now, also doing too much walking or running barefoot can
lead to plantar fasciitis as the foot has less support
than it might be used to, but also due to the impact on the heel. Now, the heel structure and the heel pad is obviously a separate structure, but damage to this area can actually aggravate the plantar fascia. If your job does involve a lot of standing and you’ve got poor posture, or your foot isn’t adequately supported, it can actually lead to
straining the plantar fascia just as the same as if
you’re an over pronator when you’re walking or running, you’re going to be constantly
over working the fascia. Now, limited dorsiflexion
can actually increase the pain in your plantar fascia, but it’s a bit of a flipped circle because it’s also a symptom for this. So, as we know fascia is very notorious for having such a limited blood supply. With that in mind, you’re going
to have to be very patient, but obviously prevention
is better than cure. Any signs of plantar fasciitis need to ideally be addressed
as soon as possible, as it can become a
rather persistent injury. Now, my first bit of
advice is to go and speak to a professional and get
a treatment plan to follow. However, today I’m going to be covering the more common treatments that have been proven to work for this injury. For this one, you want to find a small say 500 mil water bottle, pop it in the freezer and then you can use it as a massage tool. So, you want to role
your arch of your foot over the top of the bottle
for around 10 minutes a day, you can do this three or four times a day, and this will work as a massage, but also help with the
inflammation as it’s ice. Tight achilles and calves can lead to irritation of the plantar fascia. So, you need to make sure that you stretch the back of your calf, and this should be something you include in your everyday training program and it’s a good idea to work out what stretch is best for you. So, one of the options
is standing facing a wall with your feet sort of
a stride width apart, and then your back leg behind you, and you want to push your weight down through your heel until you start to feel the stretch in the back of your calf. Repeat it on the other leg, then go back to the
first leg and repeat it with a bent knee and
you’ll feel the stretch move further down your calf, and then an option which
I personally prefer, is finding a step, something
to hold on to as well, so you don’t have all of your weight going through the balls and your toes. So, stand on the balls
of your feet on the edge of the step and gently lower
your weight into your heels, and you’ll feel that stretch
again at the back of your calf, and also repeat it with a bent knee. You can take some of the
pressure off the area by making sure that you’ve
got an everyday shoe and a running shoe that has
a heel higher than the toe. Now, I don’t mean high heels in this case, but it’s probably best
to avoid barefoot shoes that have a completely flat surface and then when it comes
to your everyday shoe, especially if have you have a job that means you spend a
lot of time on your feet, look for something that’s supportive that’s just going to take
that pressure off a bit more. Gentle massage along
the length of the fascia will increase blood
flow as well as improve the malleability of the area, and you can do this either sitting down with your fingers and your thumbs and just massage it yourself, or use a golf ball and gently roll your foot around on top of it. Some therapists prescribe
this sock to wear at night, it’s a calf length sock that has a strap from the toes to the front of the calf. So, it acts to gently pull
the toes in that direction, putting on a constant stretch on your plantar fascia overnight, and this will then relieve the soreness of those first few steps in the morning. Some therapists opt to
use a cortisone injection, but there have been cases
where that’s actually caused some of the heel pad to dissolve and can obviously lead to other problems. There’s Botox, which can
help relax the muscles and structures around the fascia. Shockwave therapy is also a
favourite with some others, but obviously all of
these need to be delivered by a medical expert and only after the less intrusive options have been fully exhausted, and as we know, the fascia has a pretty
non-existent blood supply and therefore is notorious
for its slow healing. So, patience really is key, but optimally prevention
is better than cure. (energetic electronic music) Before increasing your running mileage, you need to make sure that your foot and lower leg are prepared
for the extra loading. Now, prevention is basically addressing the causes before they happen, and one of the most common
causes of plantar fasciitis is increasing your running
mileage too quickly. So, to prevent that, you basically need to
increase it gradually, and a good guide for this is the 10% rule. So, don’t increase your mileage
by more than 10% each week. Strengthening your foot and calf muscles will help make you ready
to absorb the impact and the stresses when you do
start to increase your running. So, for this, simply
you need to find a step, standing on the edge of that and you’re going to do heel raises. Start off with both heels together. So, you’re taking less of the load. Lower your heel down and then raise up on to your tip toes and back down again, and when you’ve done
this for a week or so, you can progress to
single leg calf raises, and those assisted, so
holding on to something, and then once you’ve got
more strength and balance, you can actually progress to unassisted single leg calf raises, and this will proprioception, but also really turning on those intrinsic muscles around your foot. Well, along the same lines but
with more focus on your foot, you can work to turn on
those intrinsic muscles which help control and
make a nice smooth movement from the heel strike, right
the way through to toe-off, and you can start by
just doing some exercises sat at your desk with extending your toes and then crunching your toes back up and you can do that throughout the day, and then a slightly more specific exercise you can do later on with a towel or some fabric on the ground. Use your toes to scrunch that
fabric towards your heels. Even before you have any symptoms, it’s a good idea to do some
self massaging your foot and also the medial border
down the inside of your calf as some of the muscles that
actually attach on this part will then run and come into tendons that go underneath your foot and amalgamate with that plantar fascia. So, by just loosening that it will help make the tendon sheaths and the fascia be able to move more effectively. We’ve already included the calf stretches in the cure section but hopefully if you put them into your daily routine, they can become part of
prehab and stay there, but there is one other stretch which you can add to make it
a little more specific to the actual underside of your foot. So again, come up to
the wall but this time, put your toes so they
extend now actually touching the wall and your foot
is flat on the floor and then gradually bend
your knee towards the wall and you’ll the stretch in your calf but also underneath the
bottom of your foot. (wind gusting) The main take home is look after your body and train smart. If you use the 10% rule and make sure you listen to any niggles, you should hopefully be able to avoid the onset of plantar fasciitis. Now I seriously hope that all of you guys watching haven’t experienced this injury, but if you have I’d love to know what treatment worked for you. So, please share with us in
the comment section below. If you’ve enjoyed this, give us a thumbs up and hit the globe on the screen to make sure you get all of our videos by subscribing to GTM. If you want to find some
injury prevention secrets from top pro Sebastian Kienle, that is down here and
there’s a video on knee pain and it’s prevention that Mark made, and you can find that one just over here.

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