What is it?
It is that first step in the morning that jolts your body with immense pain, tightness, and a temporary feeling of being crippled until that part of your foot warms up. Every step you take is painful, but the pain might go away by the time you are ready to go to work or do a workout. It will come back when you are sitting at your desk awhile and you stand up, or you just worked out really hard, but the pain reminds you that it is here to stay. This is what life is like when living with this condition, but there is hope for anyone who suffers from it.
Where is it?
The plantar fascia is located at the bottom of your foot, and it is the tissue that connects the toes to your calcaneus (heel bone). Plantar fasciitis occurs when an individual has flat feet, too high of arches, gains a sudden amount of weight in a short period or time, is extremely obese, pulls the plantar fascia while exercising and/or has a tight Achilles tendon and calf muscles.
Why does it hurt so badly?
The reason it hurts so badly is that when you are sleeping at night, the tissue shortens and it stays that way for hours. When you take that first step, it is forced to lengthen and it feels like you just pulled a muscle that was already extremely tight. If you look at over-the-counter options or see a podiatrist or orthopedist, they will often recommend wearing a night splint to keep your foot in dorsi flexion (i.e. flexed towards the shin). By keeping it in that position the entire duration you are sleeping or relaxing, this will keep the plantar fascia lengthened, so there is no pain associated with that first step.
If you decide not to wear a night splint, not seek medical attention, or persist in activities that irritate that area, you will run the risk of continually tearing the area that is already injured, possibly severing the plantar fascia or developing heel spurs that can be created during the healing process. If you completely tear the fascia, most doctors will prohibit you from doing any type of activity for at least one year. The severity of this type of condition is just like tearing an Achilles tendon when it comes to the recuperation time.
What are the treatment options?
If you are still wearing a night splint and continue to be active, but it still hurts, you need to stop aggravating it. Go to your medical specialist and have them take X-rays to be sure that it is not a stress fracture and that the problem has not escalated to something that is far worse than expected. If the condition is a more chronic case of plantar fasciitis, the physician may lean toward a steroidal injection of their choice (example: cortisone).
The physician will probably prescribe physical therapy in order to assess your biomechanics and to ensure that your body is working the way it should. For example, if your foot mechanics are not operating like they are supposed to, this can be a huge contributor to pressure on your plantar fascia and the cause of your injury in the first place. Individuals who have flat feet place a lot of pressure on this part of their foot because they do not have a natural arch, so they have to wear orthotics to create this feature. Their plantar fascia is already elongated, so any more pressure from activity or incorrect stretching make this condition more prevalent compared to someone with a normal arch.
In physical therapy you will learn stretches to help relieve pressure on the fascia. Calf stretches are extremely important. Icing the affected area will also relieve any swelling associated with your injury. A great way to ice this part of your foot is to freeze a water bottle and then massage the affected area to loosen the fascia but also ice it at the same time. This is not only therapeutic, but it will make the area feel a lot better when you walk. Also, in therapy they may use a muscle tens unit to activate the nerves and muscles surrounding the affected area and this can also relieve any chronic pain associated with this condition.
The most important treatment, in conjunction with everything mentioned above, is rest. Follow the recommended treatment issued for your condition and rest in order for this to heal. If not addressed, plantar fasciitis can last not only months, but years. If you are a very active person, slow down on your activities that put the most pressure on this area. For example, if you love tennis or running long distance and you are crippled after doing these fun activities, you need to stop them temporarily until you resolve your plantar fasciitis. Instead, try doing activities that are not going to create so much stress on the affected area, such as swimming, biking, or hiking.
Stay strong and avoid injury at a fitness class near you.
Other Common Injuries:
Kisar Dhillon is a professional fitness trainer living in Orange County, California. He holds a Bachelor of Science Degree in Kinesiology, Post Baccalaureate Studies in Exercise Physiology and a Masters in Business Administration. He has more than 16 years in the health & fitness industry and is currently the owner of 1-2-1 Fitness, LLC.