Plantar Fasciitis Diagnosis and Treatment

Whether you’re a seasoned marathon running veteran, a crossfitter or a new runner just starting to hit the pavement, you’ve probably already heard of the dreaded “plantar fasciitis”.  A common condition in runners, it’s characterized by severe heel pain when you stand or walk, especially after a run or upon getting out of bed each morning.  Spanning from your heel to your toe on each foot, the plantar fascia is a thick band of ligaments and connective tissue that is particularly vulnerable to inflammation in those who spend a lot of time on their feet or in ill-fitting shoes.  That means that an overwhelming number of the people seeking treatment for plantar fasciitis are athletes, soldiers, and runners.  Luckily, there are options for preventing and treating plantar fasciitis so you can either get back on your feet or stay foot-pain free!

You can start right now to check your susceptibility to plantar fasciitis.  Before your next run, slip your sneakers on and have a feel for how they fit you and how they make your feet contact the ground.  Do your ankles fall inward or outward (pronation/supination)?  Are there prominent wear marks on your shoe soles from your gait pattern?  Do you have flat feet or really high arches?  As you run, get a feel for how your foot hits the ground and how your toes, arches, and lower legs react with each step.  After you return from your run, feel your calves and Achilles tendons.  Do they hurt or feel tight?  When the Achilles tendon or calf muscles are overly tight, your foot will have a limited amount of ability to dorsiflex (bringing the top of your foot and toes towards your face) and the stress of each step will be transferred to your plantar fascia, resulting in overuse and microtears.  Though all of these signs by themselves might seem trivial, just one may point to an eventual case of plantar fasciitis, so it’s important to consult your healthcare professional now before it gets worse.  He or she will be able to tailor a customized program of exercises and treatments specifically for your body type, activity level, and musculoskeletal characteristics.  In the meantime, here are a few exercises and stretches for plantar fasciitis.  They’ll help prevent and discourage inflammation and overuse in your achilles tendons and plantar fascia. 

Achilles Tendons and Calf Muscles

Make sure you carefully stretch your calf muscles after each run, as well as throughout the day.  A great way to do this is on a set of stairs: stand facing the stairs with your toes on a stair and your heels overhanging.  With straight legs, very gently and slowly lower your heels down past the edge of the stair until you feel a slight tension but no pain.  Hold for at least 30 seconds.  Come back to the starting position for a slight variation: the second time around, keep a slight bend in your knees.  Again, hold the stretch for at least 30 seconds.  Performing this stretch with straight legs will stretch primarily your gastrocnemius, while a bent knee will allow the soleus to take the stretch.  Both muscles insert into the Achilles tendon and take a huge amount of force when running!  Show them some love by stretching them both. 

Plantar Fascia and Feet

If you have a tennis, golf, or lacrosse ball, you can use it to massage the soles and arches of your feet.  In bare feet, gently roll the ball around underneath your feet, using varying amounts of pressure and alternating between flexing your toes towards your face and pointing them down towards the floor.  This will help loosen up the connective tissue and increase its elasticity.  Initially, it may feel as though the soles of your feet are like a tight set of guitar strings, but over time they will loosen and feel softer.  Make sure you do both feet!

Before getting out of bed each morning, move your feet around by rolling your ankles and alternating between gently pointing your toes down and then up towards your face.  Scrunch up your toes and then spread them as wide as you can, hold for a few seconds in each position.  This will help mobilize the muscles of the feet and increase blood flow to an area that hasn’t moved all night.  If you’ve been diagnosed with plantar fasciitis already it likely won’t eliminate the pain, but it’s a great start.

Right before getting out of the shower, direct warm water onto your calves and feet for a minute or two.  Once you’re out, use your towel to stretch the foot and lower leg by holding onto the ends and looping the middle around the balls of your feet.  Point your toes toward your face and gently pull the towel for a stretch in the plantar fascia and calves.  Bending and straightening the knees will aim this stretch at both the gastrocnemius and soleus muscles as well.

The professionals at Arlington Pain and Rehab have a unique advantage when it comes to injury treatment: aside from undergoing a thorough education and examination process, they can stand back and take an objective and holistic look at the way you move and how your body parts work together.  For example, low back pain is a common complaint in clinics today. Before receiving treatment, most patients wouldn’t realize that their pain may actually stem from issues in their feet, knees, or hips, a far cry from their low back!  The physiotherapists and chiropractors at Arlington Pain and Rehab Clarendon can diagnose these patterns to ensure that your treatment is effective and long-lasting.  A program is always tailored to your individual needs.

During a treatment session at Arlington Pain and Rehab Clarendon, your therapist may perform heat or cold therapies, chiropractic adjustments, active release or other manual therapies, or use low level lasers to decrease inflammation in the affected lower leg and foot.   You will leave your appointment with a series of exercises and stretches for plantar fasciitis for you to perform at home until your next session.  These exercises are very important to your treatment, as are any recommendations for rest!  It’s hard to take days off from an activity you love, but rest assured that it will help getting you back on your feet much faster. Be sure to follow up with your healthcare practitioner on the state of your injury.

You only get one pair of feet, and as a runner, you want to make sure yours last, pain-free. Take care of your feet by regularly doing exercises and stretches for plantar fasciitis such as those outlined in this article, and be sure to visit your healthcare professional at Arlington Pain and Rehab Clarendon if you’re ever in doubt.      

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