Keep Moving. . . Don’t get tripped up by Plantar Fasciitis!

by Jeff Albertson

Welcome to the inaugural editorial of the new series focused on Injury Prevention and Education – provided by VASTA Performance Training and Physical Therapy. As a sports physical therapist and overall health enthusiast, I’m very excited to kick off our regular editorial focused on keeping our community moving!

I feel so lucky to live in an area full of like-minded individuals who place considerable value in their health and physical wellbeing. It is our goal to empower our community through this educational series. We want to help keep your body in top shape so that you may live the life that aligns with these values—for the long run.

Now that we can safely see winter in the rearview mirror (and for those of us who enjoy the snow, this one is a good winter to put behind us) we look forward to getting outdoors. This month we will address a common springtime injury—Plantar Fasciitis.

Sports Physical Therapists will see a spike of this diagnosis in the coming weeks—especially PT’s who treat a lot of runners. It’s a diagnosis that often evokes a grimace from long time runners as they have undoubtedly seen many friends endure long battles—some upward of 12+ months.

What is it?

The plantar fascia is a fibrous ligament that supports the arch of the foot. Think about an archery bow placed on the ground, string down. The bow represents the bones of the foot and the string represents the plantar fascia.

With each step, the arch flattens a bit, transferring load to the fascia. If the load is not controlled, with enough repetitions microscopic tears will begin to accumulate until the integrity of the structure is compromised.

What does it feel like?

Typically the first symptom is pain at the heel bone, where the ligament attaches. Heel pain, more so than arch pain, is often the primary complaint. Plantar Fasciitis accounts for ~ 80% of all heel pain; so, if you’re ramping up your outdoor activity, and you have been experiencing heel pain, there’s a good chance your Plantar Fascia is the culprit. A typical presentation includes:

  • Pain that is most prominent first thing in the morning, or upon rising from prolonged sitting
  • Pain that decreases with movement
  • Pain perceived as ‘sharp’ and ‘searing’

What causes it?

I often find myself telling patients: “The body will adapt to slow incremental changes, but it will react to large or sudden changes.”

Rapid increases in running volume and/or a sudden increase in time spent on your feet are common causes.

What to do?

  • Identify ‘Training errors’. If you are a runner, have you been ramping up your training volume too fast? A conservative (but still useful) rule of thumb is to limit increases to 10% per week.
  • Take a look at your shoe wear. Switching into ‘spring’ shoe wear may be setting you up for injury. Flip-flops are a killer; and hyper-flexible shoes of any type are a risk factor. For those minimalist runners out there—don’t get your britches in a bunch. While slowly transitioning into super-flexible shoes can be safely and effectively done for some, a sudden switch to flimsy footwear is problematic.
  • Stretch your calves and hip flexors. Tightness of these muscles increases the stress to the fascia.

If you are unable to get through your normal activities or you take these simple measures and the symptoms persist, seek help from a Physical Therapist. The nature of overuse injuries in general is that the quicker they are identified and treated, the quicker they may resolve.