By Nike Running
Here's what to know to ensure you keep running your best.
You don't have to be sidelined by this common running injury. We've got a step-by-step guide for what to do if you notice the telltale pain and expert tips to help keep your feet strong and healthy.
If you've had plantar fasciitis, you know how miserable the pain can be. If you've never experienced the injury, imagine a stabbing feeling in the bottom of your foot travelling from heel to toes.
This happens when the plantar fascia, a strong band of tissue that runs through the middle of your foot and supports your arch, becomes overstretched and then inflamed. "The more you stretch that tissue, the more likely it's going to tear", explains Ian Klein, a specialist in exercise physiology, cross-training and injury prevention at Ohio University. If that sounds like something you'd very much like to avoid, well, us too. Here's what you need to know.
What Causes the Injury
Your plantar fascia undergoes thousands of stretches every day when you walk and run, Klein says, and the tissue is very durable within a range. But excessive stress can stretch the tissue beyond what's safe. That's typically if you're training too much, if you suddenly increase your running mileage, or if you're not taking recovery days, says Kate VanDamme, a physiotherapist and orthopaedic clinical specialist at the NYU Langone Health Sports Performance Center. This isn't a newbie problem, either. Plantar fasciitis can happen to runners who look like they're pros at their sport, says Klein: "You could have perfect form and still get the injury due to training error".
Biomechanical issues, such as shortened calf muscles or a tight big toe that pulls on the plantar fascia, can also contribute to plantar fasciitis, adds VanDamme. Bad foot mechanics, like flat feet or high arches, and lifestyle issues, like a job that keeps you on your feet all day or wearing high heels often, could also be to blame.
What You Can Do
The moment you notice the telltale pain, address the inflammation, says Klein. "This is the alarm phase. You need to rest and you probably need to ice", he says. Take two days off to assess the issue. If you're able to stand, walk and do daily activities on your foot without more inflammation or pain, then it may be okay to go back to some easy running afterwards. Do not do any foot stretches at this point, cautions Klein. "Once your plantar fascia is inflamed, the tissue shortens to protect itself and heal", he says. "Even normal stretching can cause further damage".
Do exercises that strengthen your foot or ankle or increase mobility and flexibility
If you have persistent pain or your pain worsens during the 48 hours, especially following extended time on your feet, then he recommends keeping all weight off your 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, try non-weight-bearing cross-training, like swimming or riding a stationary bike.
Once you're out of the alarm phase, the next step is to do exercises that strengthen your foot or ankle or increase mobility and flexibility. Think toe raises, foot flexes and towel stretches. "We also recommend stretching the two calf muscles, the gastrocnemius and soleus", VanDamme says. You can stretch the gastrocnemius by placing your palms against a wall and stepping one foot back and bending your front knee so you're in a lunge-like position, keeping the back leg straight. To stretch the soleus, keep your front knee bent and slightly bend your back knee.
Physiotherapists can also perform manual therapy on your ankle and midfoot to mobilise the joint and improve flexibility, says VanDamme. You can do this type of soft-tissue release on your own by rolling a lacrosse ball or frozen bottle of water under your foot, she adds.
Some runners who have flat feet or overpronate, meaning their feet collapse inward when they run, use a taping technique to lift the bone on the inner side of the foot to try to prevent plantar fasciitis. But this could become more of a crutch than a solution, cautions VanDamme. "A better option may be strengthening the foot to do the work the tape would do".
However, for extreme cases, night splints can be an effective treatment. "When you're sleeping, your foot is kind of curled, so the tissues naturally will shorten", says Klein. (This is why plantar fasciitis tends to be most painful when you first 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", he explains.
How Long It May Take to Heal
Treating plantar fasciitis is different for everybody, but 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. "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".
"You can continue to run if you pull back on your training, adhere to a well-balanced training plan and remain diligent with plantar fascia and calf stretching"
Kate VanDamme, Physiotherapist and Orthopaedic Clinical Specialist
However, that doesn't mean you have to hang up your running shoes throughout your recovery. "You can continue to run if you pull back on your training, adhere to a well-balanced training plan and remain diligent with plantar fascia and calf stretching", says VanDamme. If your pain persists, you may want to seek care from 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 May Help
The type of shoes you wear could help you deal with plantar pain and help prevent plantar fasciitis from occurring, says VanDamme. "Typically, a more supportive shoe is best", she says.
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 aid overpronation, which can contribute to plantar fasciitis. Look for shoes that provide extra stability and cushion at the heel as well.
Tips to Prevent Plantar Fasciitis
First, improve your form. One easy way to do it: Take a video of yourself from the side and see where your foot lands.
If your foot is way out in front of you, you're overstriding and your heel is acting like a brake. "The ground sends a force up the lower leg, which actually slows you down", says licensed physiotherapist and Nike Performance Council member Derek Samuel. Many recreational runners overstride, says Samuel, and it's a major issue because it can create so many injuries, including plantar problems. "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.
Perhaps the smartest move to steer clear of plantar fasciitis, or any injury, is to make training choices that keep your body healthy and strong: ramp up mileage slowly, work in regular strength training, take recovery days. Permission to go easy once in a while, granted.