One of the most common and perhaps the most frustrating running injuries is plantar fasciitis. It is especially common in new runners, those that increase mileage too quickly, people with high arches, runners carrying a few extra pounds, or those with rigid lower quaters and tight calfs.

What is it?
Plantar fasciitis is a term that describes an overuse injury to the fibrous material underneath the foot, ordinarily functioning as a shock absorber and arch support. Its cause is repetitive microtrauma to the fascia that runs from the heel longitudinally to the ball of the foot. Often the pain can be felt under the heel and is commonly refered to as a heel spur, although a spur (or bony protrusion) is not always present. Imaging can detect the presence of calcium deposits, a thickening of the fascia or edema. Plantar fasciitis can worsen with repetitive impact activities and may be most prominant after long durations of inactivity, such as in the morning just after waking up.

What Can be Done About It?
The treatment of plantar fasciitis requires patience. It is important to realize that many runners aquire this injury during training. With patience, discipline, and a little flexibility it can be treated without detrimental effects on your training.

Initial Treatment
If you think it could be plantar faciitis, begin by taking a few days off from your running. Ice, stretch, and massage along with ibuprophen should help address the initial insult and associated swelling. Manual manipulation of the area to break up adhesions or scar tissue, and to stimulate the natural repair process, may also be helpful. An inexpensive way to do this is to roll your foot over a golf ball wrapped in athletic tape or a frozen coke bottle.

If you have access to a pool, swimming or kicking with a kickboard and fins may also be helpful. This will engage the flexors and extensors of the foot and ankle to aid repair.

To begin to strengthen the underlying structures, perform towel grabs daily with your toes. Sit in a chair and lay a towel in front of you. By using your toes only, grab the towel and pull it little by little with your toes until the entire towel is under your feet. Start at one end and stop when you have grabbed and pulled through the entire length of the towel.




A rigid lower quarter (knee through the foot), over pronation, and poor running mechanics creates additional shock to be borne by this structure instead of the having it dissipate evenly across the arch, knees and ankle joints. A lack of flexibility in the gastrocnemius and soleus (calf) muscles can contribute to this, so consider additional stretching, and massage using the golf ball on the peronius and the other lower leg muscles to break up adhesions. Longer duration low-grade stretches are particularly helpful to address the cause of this condition. Use a night splint, which places your foot in a slightly dorsi-flexed position.





The night splint does not need to place your foot in an extreme stretched position for it to be effective. Anything to reduce the ability for you to point your toes while sleeping will help. Even without a night splint, you might find that untucking the sheets at the bottom of your bed will help to reduce your ability to point your toes and take it out of that shortened plantar flexed position.


Getting Back to Running
To get back to running, follow these easy steps. Begin with non-weight-bearing activities such as aqua jogging in the deep end of a pool. When pain free in these activities, move on to weight-bearing, non-impact activities such as an elliptical machine or Stairmaster.

As you move into weight bearing activities you can support the healing process and reduce the possibility of re-injury by using tape or an arch support during the activity and ice immediately afterward to minimize unproductive swelling.



Taping the arch from the ball of your foot to your heel creates a "fake arch" so that upon weight bearing or impact, the foot doesn't flatten all of the way out and the tape takes the stress of the weight or impact rather than the structure itself.

An arch support such as this one from Pro-Tec is convenient to use and can also help to prevent the foot from flattening out during exercise or walking.



As you transition to running, begin on softer surfaces such as grass, dirt, or a treadmill to further reduce the impact to the area. On a treadmill you also can stop if the discomfort returns. This is not an injury that you should run through. If you are in the middle of a run and the pain resurfaces, stop running immediately and walk back. Initial runs should be short in duration and more frequent until the rehabilitation process is complete.

The Effect of Weight
As mentioned earlier, plantar fasciitis can be caused or exacerbated by sudden weight gain. Weight management should be a consideration in any training program to ensure the highest level of performance.

Increase in weight is not limited to an increase in body fat. Plantar fasciitis has also been identified in athletes who have undergone a serious weight-training program during the off season. The use of preventative supportive techniques should also be considered if increasing mileage when you are carrying more weight than usual.

By following the prescribed rehabilitation process above, you won't lose endurance; perhaps a little speed, but that's okay. The ultimatel goal is to return as fast as possible to effective and consistant training so you can complete your event healthy and injury free.

As with any injury, consult your doctor especially if:

• Your arch or heel pain continues after two weeks of self-care.
• You feel sharp, shooting pain even at rest (sitting and sleeping).
• You can't walk without limping.
• Your arch or heel swells.
• You feel unusual numbness or tingling in your foot (possible circulation or nerve problems).
• Your foot or toes are blue and cold (possible circulation problems).
• Your heel, foot, or toes are red and hot and you have a fever (possible infection)

The information included in this Web site is not intended to be medical advice. For further information consult your doctor or other healthcare professional.