Don’t Let Foot Pain Keep You off the Podium

Who isn’t inspired after watching weeks of the Olympics? We sat flipping channels as gymnasts and divers flipped in unimaginable ways and thought “no way!”—but then Usain and company lined up on the track and suddenly a few laps seemed a little more plausible. Hey, I can run, you realize. Maybe not at lightning speed, but that’s okay. Your inner Olympian can jog with the best of them.

That is, until a sharp, often excruciating pain flares up at your heel, and maybe shoots down the middle of your foot.

Plantar Fasciitis is one of the most common foot injuries and common causes of heel/foot pain, and runners, especially middle-aged adults, are prime candidates for it. But even if you’re not lacing up and hitting the track to indulge your Olympic fantasies, you can be sidelined by Plantar Fasciitis. So let’s take a look at what it is and how you can prevent it.

What is the Plantar Fascia?

The Plantar Fascia is a strong, flat band of tissue/ligament that connects your heel bone to your toes. The purpose of the fascia is to provide support to the arch of your foot. The Plantar Fascia can be strained or over stretched, which causes it to get weak, swollen and inflamed. It will then hurt when you stand or walk. Exact causes of Plantar Fasciitis are not well known, however it probably develops as the result of repeated small tears in the fascia.

What are the symptoms?

The classic symptom of Plantar Fasciitis is pain in the bottom of the heel when you take your first steps after getting out of bed in the morning or after sitting for a long time. The stiffness and pain in the morning or after resting improves after a few steps but gets worse as the day progresses. You may feel similar symptoms at the beginning of exercise, and the pain may actually get better or even go away as exercise continues but it eventually returns when the exercise is completed.

How does it develop?

Plantar Fasciitis usually develops gradually, and early symptoms may only be pain with the first steps of the day or after sitting. There are several conditions or activities that may lead to it, including:

• Over pronating, or having high arches, flat feet or tight muscles and tendons in the back of the lower leg
• Repetitive activities, such as prolonged walking or standing on hard irregular surfaces or sports such as running
• Anything that puts extra strain on the feet, such as being overweight or wearing shoes that are poorly cushioned or worn out

How do I treat it?

Plantar Fasciitis treatment can be successful but it can take weeks or months for the symptoms to resolve. If the foot is not rested, then the pain will get worse. The injured ligament will remain inflamed and may never heal completely if you are not able to stop the activity or change the condition that caused it. Treatment is aimed at relieving inflammation and allowing small tears in the Plantar Fascia ligament to heal. Treatment also seeks to improve strength and flexibility in the foot, which will help to decrease stress to the ligament and stabilize the foot, preventing recurrence.

Home treatments that can help to alleviate the symptoms include:

• Applying ice to the heel using a frozen water bottle
• Resting your feet and wearing supportive footwear with good arch support or heel cushion
• Using arch supports for your running shoes which helps decrease stress to the fascia
• Taking ibuprofen or naproxen to help reduce pain and inflammation

If symptoms continue then you should consult your local foot surgeon for treatment.   Options would include physical therapy, orthotics, and cortisone injections, and if those treatments are unsuccessful then potentially surgery.

How do I prevent it?

There are several methods to help prevent Plantar Fasciitis or help keep the condition from getting worse if you already have it.

• Take care of your feet by wearing shoes with good arch support and heel cushioning. Avoid wearing flip-flops, going barefoot or slippers.
• Do exercises to stretch the Achilles tendon at the base of the heel – this should be especially done first thing in the morning and before activity
• Increase you exercise levels gradually, and wear supportive shoes

By Jeff Armstrong, DPM, ATC with Roper St. Francis Physician Partners