A Pain in the Foot: Tips for Dealing with Plantar Fasciitis

Disclaimer: I am not a doctor or physical therapist. These suggestions are based on my experience as a personal trainer and fascial stretch therapist, as well as my own history of dealing with plantar fasciitis. Plus, many of my blogging and running friends were kind enough to share their best tips.

Has this happened to you? You have a great night’s sleep. You wake up, sit up, stand up. As you start to walk away from your bed you feel it. A sharp pain in your heel that reduces your walk to a shuffle.

After you take a few steps, it seems to improve and after several minutes you may not even remember the pain. At least until you stand up from your desk a few hours later, when the same thing happens.

What you have, my friend, is probably plantar fasciitis, an inflammation of the plantar fascia, the thick band of tissues that runs along the bottom of the foot and connects the heel bone to the toes. Runners are particularly prone, as are pregnant women, overweight people, and those who wear shoes with inadequate support (think of those cute, strappy sandals that you love).

If you want to read more of the clinical description, cause and treatment of plantar fasciitis check out the Mayo Clinic website. I’m here to discuss my long history with the inflammation, how I’ve dealt with it, and what is working for me to treat and prevent it.

My Experience with Plantar Fasciitis

My first experience with plantar fasciitis occurred in 2001. I was putting in big miles and running a lot of marathons. I fell in love with a lightweight shoe, the same brand as my long time trainers that had seen me through more than 25 marathons (the model, not the same shoe!). This new shoe felt so good and it was so much lighter! It also had a lot less support, and eventually, after several months, that did me in. I started to experience everything mentioned in the first paragraph.

I didn’t let it slow me down, though I did switch back to my other shoe after my chiropractor (who was also a runner) suggested that “it must be the shoes.” I kept running, though, until finally my foot not only hurt when I woke up in the morning, it pretty much hurt all the time, even when I wasn’t running. Oh, did I say foot? I meant feet, because I had plantar fasciitis in both.

Plantar Fasciitis Treatment

At that point I did start running less. I tried all the treatments, including icing, rolling, anti-inflammatories, stretching, strengthening exercises, I slept in the boot, I slept in the sock. I taped my foot, not just before a run, but every day. I always wore supportive shoes, never walked barefoot. Let’s see, what else? Oh, finally at the end of my rope, I got a cortisone shot. Three, actually. Two in my right foot, one in my left. They helped a little bit, but not enough. I was still in pain.

I have heard it said that plantar fasciitis will sometimes just simply go away, as quickly as it came. That after months of trying different treatments, it just suddenly gets better. That is not what happened with me.

What did happen was that I hurt my knee. I do not recommend this as a plantar fasciitis treatment, but I can honestly say that the time that I finally took off from running because of my knee injury gave my feet the time to heal.

When I returned to running, several months later, I stuck with my supportive shoes, ran a lot less mileage, and continued to stretch and take care of my feet. They were finally healthy and remained that way until a couple years ago when I started training a little more seriously and running more. When I felt a twinge in my heel I immediately upped my foot care, and I haven’t had a problem since then.

Fascial Stretch Therapy

I didn’t know about fascial stretch therapy when I was dealing with my own plantar fasciitis. If I had, it would have been my first step to resolving the factors that were causing my pain.

In general, most treatment for plantar fasciitis involves chasing after the symptoms without really addressing the problem. While stretching of the foot and calves are frequently suggested, that is as far as it goes.

Understanding that the cause of the problems probably goes way beyond those areas, a Fascial Stretch Therapist will assess the entire back line of your body, from your toes to your skull. Frequently, pain in one part of the body is the result of a weakness, imbalance, or tightness in another. The therapist will address this in their program and create a plan to correct the issues.

If you live locally (in the Coachella Valley), I offer in-home Fascial Stretch Therapy. Check here for more information.

Advice from Runners

I spoke to several runners to ask them what worked best for resolving their plantar fasciitis. Here are their tips.

From Wendy of Taking the Long Way Home: I’ve tried everything, and I mean everything. Except ART–I am scared of it! I finally went to a sports medicine specialist. Time off to let my foot calm down helped me the most.

Since I was in the middle of marathon training, I substituted pool running for my runs. Besides giving me a workout similar to running (without the pounding) pool running helped me with my running form! That was a benefit I hadn’t even considered.

Cycling is a good backup plan too, but it does work your calves and achilles, so you have to stretch those out after a ride.

A lot of people mention orthotics as being helpful but I’ve never had good luck with either the custom or the store bought ones until my doctor recommended Spenco orthotics. They are flexible while most orthotics are rigid, and they have been a game changer for me.

I am back to my baseline mileage now. Looking forward to pushing ahead (slowly) to prepare for a fall half.

From Coco of Running with Perseverance: The “miracle cure” for me was Graston therapy (instrument-assisted soft tissue manipulation) by a chiropractor. It hurt like heck but the results were worth it. For prevention, stretching my calves and wearing supportive shoes all the time.

From Kim of Running on the Fly: I scaled back my mileage a lot. I had a couple half marathons and an ultra that were more important than “mileage numbers.” I also taped my arch (to help keep everything as tight & fully supported as possible). Even though I’m recovered, I still tape my arch for long runs & don’t overdo the mileage.

I also did a lot of calf stretching throughout the day, intermittent massaging and rolling on a frozen water bottle.

From Sarah of the Fit Cookie: I had plantar fasciitis several years ago and for me it actually stemmed from tight calves and adhesions on my achilles and heel. I use a foam roller to roll out my heel and achilles and did a lot of calf stretching and it went away.

From Julie of Running in a Skirt: I’ve used a frozen plastic water bottle. Roll your heel on it and it really helps!

From Janelle of Run with No Regrets: I suffered from PF after wearing the wrong type of running shoes. What helped me the most was stretching my calves, doing heel drops, and yes, I had to significantly cut back on running for a couple of months. I also started wearing Superfeet insoles.

From Sheila of the Frugal Exerciser: Rest and I had to rest for 6 months. I cycled and took up spin classes.

From Esther of Chocolate Runner Girl: I got these toe stretchers that I wore every night for 5-10 min after I foam rolled. They helped a ton!!

From Angela of Marathons and Motivation: I wore a brace at night that kept my toes flexed, it really helped! In fact, any time the PF starts rearing it’s ugly head, I use the brace and it helps to alleviate it.

From Deborah of Confessions of a Mother Runner: I did everything you could do and bought every product out there! In my opinion, the only thing that really helps is to take time off from running until it heals. Stretching, massage and icing daily were my routine.

From Sarah of Creating Better Tomorrow: Deep tissue massage…I tried inserts, i tried cortizone…nothing…massage on foot! Miracle!

From Jennifer of Runs with Pugs: The most effective, on top of rolling, stretching and icing, has been alternating foot baths: I fill one plastic tub with water as hot as I can stand, and the other with ice water. Then I alternate holding my foot in each for about 10 seconds until I feel a throbbing in my arch. This simulates a blood pump which gets the oxygenated blood moving and helps to repair the micrometers in the fascia.

From Mark of Train with Marc: Freeze a water bottle and roll out the entire foot. A golf ball works well too, but isn’t cold. Stretch calves and hamstrings (all are connected).

Thanks to everyone who contributed!

Prevention

While runners are at increased risk for developing plantar fasciitis, there are a few things you can do to decrease that risk. If you have suffered from PF before you may be more likely to develop it again. When you feel that first twinge, as with other potential injuries, don’t ignore it. Here are some other things you can do to prevent plantar fasciitis.

1. Wear supportive running shoes
2. Use orthotics if recommended by your doctor or therapist
3. Limit wearing flimsy (though cute) footwear when not running
4. Avoid walking barefoot, especially if you have tile or other hard surface flooring.
5. Strengthen your feet and calves
6. Activate and strengthen your glutes
7. Engage in a regular total body strengthening program
8. Stretch consistently (See here and here for a great functional stretching program for runners that is based on the principles of Fascial Stretch Therapy)
9. Use a foam roller, tennis ball, or other tool to release trigger points and help blood flow. In addition to your feet target glutes, hip flexors, calves, IT band and any area that is tight or sore.
10. If possible, have a regular massage or fascial stretch therapy
11. Don’t ignore symptoms and allow a twinge to turn into an injury

Have you dealt with plantar fasciitis? What helped you the most? Any suggestions that I missed?

 

And Now It’s Time for the Running Coaches’ Corner!

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