Plantar Fasciitis is a common diagnosis of heel pain in runners. But just because it's common does not mean that it can be ignored. Usually it's too painful to be ignored and the worst part about it is that it can take weeks to heal. That is why we should be careful to prevent this injury and if we do develop it take care with the fastest route to rehabilitating the tissue.
The Plantar Fascia (or plantar aponeurosis) is a thick, fibrous tissue which originates on the heel (calcaneous bone) and then extends out along the sole of the foot to the toes. If you take your foot and bring your toes toward your heel in dorsiflexion you can feel a tissue becoming tight and then loose again with you relax and bring your toes away from your heel. This is the plantar fascia.
This tissue's job it to help maintain stability in the foot by holding the arch of the foot. It's what makes the spring in your step.
Due to its function of stability, the plantar fascia prevents the foot from rolling inwards too much but overuse and overtime this will cause the fascia to become stretched and to rip away from it's insertion on the heel which leads to pain and/or inflammation. Boom! Plantar Fasciitis.
Plantar = foot, Fascia = fiber/tissue, "itis" = inflammation. So Plantar Fasciitis = inflammation of the fibrous tissue on the bottom of the foot.
A lot of tension is placed on the plantar fascia when the toes are extend and when the arch is lowered from weight bearing (eg. Coming down on your foot in a running step). If the weight of the body is falling on the heel the tension is almost insignificant whereas putting your weight on the balls of your feet (toes) will greatly increase the tension.
As runners we are constantly extending our toes and pushing forcefully with the balls of our feet to push off the ground which places a great amount of tension on the plantar fascia.
Other causes that have been researched that tend to plantar fasciitis are:
Some causes can be easily prevented with the necessary precautions. Running too much, too soon at too high of an intensity places stress on the tissue. Shoes that are too flexible and too over worn cause stress as well. Don't wear shoes for forever and ever, and ever and ever. Every 300-500 miles is about the limit.
The pain of plantar fasciitis usually starts in the heel bone and will eventually move down to the body of the fascia (the middle of the bottom of the foot).
One of the first signs is having heel pain when you wake up in the morning. This is due to being off your feet all night and placing your body weight on a rigid and tense plantar fascia. As the injury develops this can become very severe but usually lessens as you start to walk around.
The fascia will normally become inflamed and sore if not treated as soon as possible. This inflammation can be avoided (and should be at all costs) if you take the necessary precautions as soon as you start feeling the pain.
Treatment should start before inflammation occurs and as soon as you feel heel pain in order to prevent having to take off weeks (yes! Weeks! Not at all uncommon for it to continue anywhere from 8-12 weeks.) from your running routing. As with all injuries and especially this one, prevention is key!
Stretch the plantar fascia at least 3 times a day. Here are some simple techniques:
Don't skimp on your stretching! It reduces pain. Also stretching your plantar fascia regularly is a great prevention aid in avoiding plantar fasciitis.
Don't lose hope if you are experiencing plantar fasciitis. Most runners, after the proper treatment, have gone on to be even better runners.