Plantar what?

A majority of patients with plantar fascitis tend to be overpronators with lower arches.
It starts out as a little soreness in your heel after a run, but it goes away by the next day -- no big deal.

A week later, you start to notice the pain in your heel after every run. The pain goes away though, just another minor ache that all runners have to deal with.

Then it starts to hurt every morning when you take your first few steps out of bed and you have to do the "furniture shuffle"-- walking with one hand on the couch or bed to support your body weight until the pain subsides. Now it's a little concerning; what could it be?

The answer is plantar fascitis, a very common problem among both runners and non-runners alike. It's an inflammation of the plantar fascia (connective tissue of the foot) where it attaches on the bottom of the heel.

The fascia itself is very strong, however the attachment on the bone is vulnerable to repetitive stress and gets irritated over time. If it's not treated, it can become chronic and can lead to bone spurs at the attachment point of the fascia.

Clinically, we notice that a majority of patients with plantar fascitis tend to be overpronators with lower arches, but this isn't always the case. In a recent study published in the Journal of Bone and Joint Surgery, physical therapists at Virginia Commonwealth University found an increased incidence of plantar fascitis in people who spent the majority of their workday on their feet, those who were obese, and those with poor calf flexibility.

It should be noted that this study wasn't specific to runners, but there's much that runners can learn from it. For instance, did you gain a few pounds over the off-season? Do you spend all day on your feet in addition to your time spent running? Are your calves tight? These are all risk factors that increase the chance of developing plantar fascitis.

Preventive measures

So what's a runner to do? If you start experiencing any of the symptoms mentioned above, there are several things you can do on your own.

  • First, back off a little on your mileage and replace it with cycling, swimming, or an elliptical machine.
  • Stretch your calves several times per day by putting your toes up on a step or curb and leaning forward, holding the stretch for up to 60 seconds.
  • Stretch your plantar fascia frequently by grabbing your toes and pulling them upward (the plantar fascia will feel like a tight band running the length of your foot).
  • Ice the area 10 to 15 minutes every evening or after a run.
  • Make sure your running and everyday shoes support your arches. If they don't, consider buying some insoles that offer better arch support.
  • Avoid going barefoot.
  • Do some self massage to the arch area for 5 to 10 minutes every morning.
If you've faithfully tried the above and are still having symptoms after two to four weeks, then it's time to get some professional help and see your health care provider. Treatment can include custom foot orthotics, night splints/socks, pain relieving modalities, manual therapy, anti-inflammatory medications and injections.

Most importantly, seek treatment promptly. The longer plantar fascitis continues, the harder it is to treat and the more it can interfere with your training.


Physical Therapist and duathlete Cody Barnett specializes in treating runners, cyclists, and multisport athletes. For injury treatment or to receive free injury prevention information, visit www.BodyworxPhysicalTherapy.net.

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