Friday, 2 May 2008

Plantar fasciitis treatment

The Fat Runner's foot is feeling much better after three weeks of rest and quite a lot of care. If you also have the same kind of heel pain he has, then here are a few things you can do.

The first thing to bear in mind is that these ways of treating plantar fasciitis were recommended to him by a physiotherapist and a podiatrist who did in depth analysis of what was going wrong. Both said that plantar fasciitis is normally caused by a range of different issues which together work to stretch the plantar fascia more than it is designed to stretch.

In TFR's case, these issues included:

- Foot mechanics - overpronation throughout the stride
- Running style - midfoot foot strike rather than a heel strike (which is better for heavier runners, even though most magazines seem to say not to heel strike...)
- Weight - obviously
- Lack of flexibility in calves
- Lack of flexibility in hamstrings
- Poor core strength

What was interesting is how they both identified issues way away from the foot which were contributing to The Fat Runner's plantar fasciitis.

So what is the treatment?

Four core pillars (for now at least)

- stretching
- strengthening
- ice
- massage

And this is all underpinned by rest - no running or even cycling for a while...


A number of key stretches were suggested - all basically to loosen up the calf and the hamstring. Calf stretches are being used to target both main muscles in the calf. Up until now, TFR didn't know you had to do two different calf stretches - one to target each muscle. Because the plantar fascia is attached to the heel, and the heel is attached to the calf and so on, loosening up the back of the leg will reduce the stress on the plantar fascia.


Two key strengthening exercises. Firstly, heel raises (isolated on one foot at a time to increase the pressure - the other foot in the air). Secondly, using a large rubber exercise band to strenghten the rotational strength in the foot (turning the toes of one foot in towards the other foot. These exercises should stabilise the foot more so that it collapses less on impact, again reducing the stress on the plantar fascia.


Used to reduce inflammation more quickly. The plantar fascia has very little blood supply so takes much longer to heal than a muscle - hence icing should be done for as long as possible (weeks) rather than the couple of days you normally ice muscles for.


Useful to increase bloodflow to the area around the plantar fascia and break down scar tissue in the area.

On top of this, TFR has to rest.. A lot... So no running or even cycling for now. So he is keeping up with weight training.

In a few weeks, the recovery regime is likely to move from stretching towards core strength work, something TFR has done very little of in his time. And if he's honest, he has done very little stretching as well (until now).

Looks like his oversight is now catching up with him...


Anonymous said...

Plantar fasciitis is a horrible running injury. I am 5'11" carrying 200 lbs while running to lose weight and gain fitness. And believe me, the younger you are the faster you heal. This "masters" 48 year old runner has had PF since last November after running 3 marathons in the fall, I saw my doctor and took 6+ off from running. I am now just getting back into a little running, 3 miles every other day. If it takes taking two days off, I do that. Here is what has worked for me, 1) Birkenstock sandals - never walk barefoot if you have PF, wear "flip flops" in the shower as well, 2) I run now in Supernovas with a Birkenstock Sports cork insole and then two layers of Dr. Scholls before I shove my feet in the shoes. 3) ice after running, shower, then back into the Birkenstock sandals. 4) wear one of those Strasborg socks at night. 5) Stretch often. Most importantly, if you have pain in your arch in the morning when you first get out of bed, DONT RUN!! Hang in there, you'll heal. PF takes time....