Save Your Feet From Fasciitis
The F-word could derail your running routine for months. Here's how to fight back.
If you're a runner, you've probably at least heard of plantar fasciitis, the foot issue that's just as weird to spell as it is to pronounce. Hopefully you haven't experienced it: a stabbing feeling in the bottom of your foot travelling from your heel to your toes. If you have, sorry! But at least we can help you understand why it happened and help you avoid it—toes crossed—from happening again.
What Causes Plantar Fasciitis
Mini bio lesson: A strong band of tissue called the plantar fascia runs through the middle of each foot and supports your arch. The fascia undergoes thousands of stretches every day when you walk and run, and it's very durable within a range, says Ian Klein, a specialist in exercise physiology, cross-training and injury prevention at Ohio University. Key words: within a range. Excessive stress—from training too much, suddenly increasing your mileage, or not taking recovery days—can stretch the tissue beyond what's safe, says Kate VanDamme, a physiotherapist and orthopaedic clinical specialist at the NYU Langone Health Sports Performance Center. From there, it can become inflamed and tear, says Klein.
This isn't always a newbie problem. Plantar fasciitis can happen to veteran runners who might be training too hard, says Klein. Biomechanical issues, such as shortened calf muscles (from not stretching) or a tight big toe (from running hard on your feet) that pulls on the plantar fascia, can also contribute to the problem, adds VanDamme. If you have flat feet or high arches, stay on your feet all day for work, and/or wear high heels often, your risk goes up, she says.
Excessive stress—from training too much, suddenly increasing your mileage or not taking recovery days—can stretch the tissue beyond what's safe.
How to Fend Off Fasciitis
First and foremost: The moment you notice the telltale stabbing pain, address the inflammation. "This is the alarm phase", says Klein. Ignore your barking dogs and you could end up sidelining yourself for weeks or months. Here's what to do:
- Take two days off to assess the issue, using that time to rest and ice your feet, says Klein. By then, if you're able to stand, walk and do daily activities on your feet without more inflammation or pain, then it may be OK to resume some easy runs.
- If your pain worsens during those 48 hours or persists afterwards, try your best to keep all weight off your achy foot. "Do this until the inflammation and pain are at a minimum or gone completely", says Klein. To ease into putting pressure back on your feet (and get your fitness fix), try non-weight-bearing cross-training, like swimming or riding a stationary bike.
- Once you're out of the alarm phase (congrats!), start doing exercises that strengthen your foot and ankle, as well as ones that increase mobility and flexibility. Think toe raises, foot flexes and towel stretches (Google is your friend here—just look for videos from a licensed physio). "We also recommend stretching the two calf muscles, the gastrocnemius and soleus", says VanDamme. You can stretch the gastrocnemius by placing your palms against a wall, then stepping one foot back and bending your front knee so you're in a lungelike position, keeping the back leg straight. To stretch the soleus, keep your front knee bent and slightly bend your back knee.
- If you want to take things a step further, a physiotherapist can perform manual therapy on your ankle and midfoot to mobilise the joint and improve flexibility, says VanDamme. You can also DIY this type of soft-tissue release by rolling a lacrosse ball or frozen bottle of water under your foot, she adds.
- For extreme cases—your physio/sports doc should let you know if that's you—a night splint (don't laugh) can be effective. "When you're sleeping, your foot is kind of curled, so the tissues will naturally shorten", says Klein. This is why plantar fasciitis tends to be most painful when you step out of bed in the morning. "A splint keeps the foot in a stretched position, so when you wake up, it hasn't shortened, and it's easier to put pressure on it", he explains.
The one thing you don't want to do, other than run a load of miles on inflamed feet? Stretch your feet on your own. "Once your plantar fascia is inflamed, the tissue shortens to protect itself and heal", says Klein. "Even normal stretching can cause further damage".
How Long It Could Take to Heal
Treating plantar fasciitis is different for everybody, but, no surprise, the earlier you take action, the better, says Klein. "I've seen people get better in as little as one month if they catch it the day it starts hurting", he says. On the flip side, "keep running on it without doing anything to address the issue, and it can take three to four months of rest to get it back to full health". That said, studies show it often takes about six months to resolve the issue.
But wait! That doesn't mean you have to throw your running shoes in a dusty corner throughout your recovery. You can still run if you pull back on your training and do the strength-building and calf-stretching exercises mentioned above, says VanDamme. If your pain continues, you may want to check in with an orthopaedic specialist. "If you're doing the right kind of treatments and it's not going away, you want to make sure it's not something else, like a stress fracture or pain radiating from another area", she says.
Why Shoes Could Help
To deal with plantar pain and help prevent full-blown fasciitis from striking in the future, take a look at your shoes, says VanDamme. Because the plantar fascia supports the arch of your foot and absorbs shock when you walk and run, a stability shoe with a firmer midsole on the arch side of the foot and a lighter, softer foam on the outside can maximise shock absorption and counter overpronation, which can contribute to plantar fasciitis. Look for supportive shoes that provide extra stability and cushion at the heel. They might be heavier, but if they fight fasciitis, they're worth it.
How Your Form Plays a Role
You may not realise this, but a lot of recreational runners take steps that are way too long for their body, which is called overstriding, says Derek Samuel, a licensed physiotherapist and Nike Performance Council member. You can tell by having a friend take a video of you running from the side: If your front foot is way out in front of you, you're overstriding, and your heel is acting like a brake. Overstriding can not only lead to plantar problems, it also can slow you down as your lower legs absorb more force from the ground, says Samuel.
"Look at elite-level athletes. They land with their heel right underneath their centre of mass, leg perpendicular to the ground", he says. This keeps the pros—and any runner—moving quickly and efficiently. To create that effect, Samuel tells his patients to try to take more steps per minute, imagining they're in a controlled fall forward.
Your feet may not seem like the sexiest or coolest body part to pamper and protect, but in a way, your runs start and end there. Keep them happy, and you'll likely never have to pronounce that ugly F-word again.
Words: Ashley Mateo
Illustration: Gracia Lam