Plantar fasciitis (or fasciosis) remains one of the most common foot injuries that dashes the training and racing hopes of many runners. Tell-tale signs of the condition include sharp pain in the heel when getting out of bed in the morning, and again when standing or walking after sitting for long periods. The tricky thing about plantar fasciitis/fasciosis is that many athletes can continue to run with symptoms—the condition has to be pretty severe to make a stubborn runner with a high pain threshold stop training. Even trickier: If a runner uses the right tools to treat plantar fasciitis/fasciosis, and commits to strengthening and stretching the affected area, he or she can continue to run at a low to moderate level until symptoms improve. Find out how to be that runner.
What Is Plantar Fasciitis and What Causes It?
Plantar fasciitis is becoming known as "plantar fasciosis" among the sports medicine community, and new evidence challenges the previous idea that plantar fasciitis is caused by inflammation of the plantar fascia. A study published in 2003 in The Journal of American Podiatric Medical Association failed to show evidence of inflammation in tissue samples taken from patients diagnosed with plantar fasciitis. An article published in Podiatry Today supports this evidence, claiming that plantar fasciitis is not inflammatory, but rather degenerative—meaning it causes the death of plantar fascia tissue.
The most common symptoms of plantar fasciosis include: heel pain that happens when taking your first steps out of bed in the morning, and heel pain that occurs when standing or walking after a long period of sitting.
MORE: How to Prevent Foot Pain
5 Beneficial Barefoot Exercises for Plantar Fasciitis
While ice, rest, orthotics and pain relievers may ease the discomfort, the injury can come back again (and again) unless you address the underlying cause—weak and tight muscles and tendons that make up and support the foot, says Irene Davis, Ph.D., P.T., director of the Spaulding National Running Center, Harvard Medical School in Cambridge, Massachusetts.
If arch pain is your nemesis, Davis recommends doing these five daily exercises barefoot.
How to Run Safely With Plantar Fasciitis
When Ella Johnson of Jacksonville, Florida, was sidelined with plantar fasciitis three years ago, she ran in the pool six days per week for eight months. "It was a way for me to still enjoy my favorite sport even though I was injured," Johnson says. "When I was ready to hit the roads again, my 5K times were comparable to what they had been before...even though I hadn't actually 'run' in months!"
Can Botox Cure Plantar Fasciitis?
If you've had heel pain for more than three months, tried other therapies with no success, and are willing to pony up for relief, ask your doctor about these innovative procedures: extracorporeal shock wave therapy, platelet-rich plasma, botox, dry needling.
Are You Wearing the Right Socks?
The reason plantar fasciitis is so tough to defeat is that most of the healing occurs at night, when the ankle is extended and the fascia shortened. As soon as you get out of bed in the morning and put weight on the foot, the fascia stretches out and all that healing is undone. The Strassburg sock is a special sock worn at night that keeps the ankle flexed to allow the fascia to heal at a functional length, and often brings miraculous results to plantar fasciitis sufferers.
MORE: The Best Running Socks
Should You Go Without Shoes?
It is estimated that over 75 percent of shod runners are rear-foot strikers (landing heel first). Rear-foot strikers who do not properly transition to forefoot or mid-foot striking bear a greater risk of severe injury. By continuing to land heel first, the shock on the body without the cushioning of running shoes leads to a considerable number of fractures (both stress fractures and full fractures) in the heel area or tibia. Likewise, converting to barefoot running too quickly can lead to a much higher incidence of metatarsal stress fractures and plantar fasciitis.
MORE: 4 Ways to Fight Plantar Fasciitis
Your Weaknesses Don't Originate in Your Feet
Many injuries can occur from weaknesses in the hips, including plantar fasciitis. Since the hips stabilize each leg during the stance phase of the running gait, strength in that area is particularly vital. Washington D.C.-area running coach Jason Fitzgerald has his athletes try a one-legged squat to determine hip strength. "You should be able to squat down so your femur is about parallel with the ground and your knee remains pointed straight ahead," he says. "If you're wobbling all over the place and your knee collapses inward, you have hip weakness."
Try these five hip-strengthening exercises to help combat plantar fasciitis.
Will Changing Your Running Form Help?
Form follows function, and you can't jump directly into running form improvements without making the right investments in strength and coordination. This may involve fixing imbalances, improving your mobility, or overcoming inherent weaknesses. Shortcutting this step is a major cause of issues such as Achilles tendinitis or plantar fasciitis arising from the use of minimalist running shoes.
Can Heel Pain Be Cured in the Toes?
"Most people are unaware that the answer to plantar fasciosis is in the toes," says Ray McClanahan, DPM, sports podiatrist, founder of Northwest Foot & Ankle in Portland, Oregon, and long-time competitive distance runner. "Repositioning the toes to the location nature intended—splayed and in line with their corresponding metatarsal bones—reduces tension on the flexor retinaculum and allows sufficient blood flow to reach the plantar fascia tissue."
Dr. Ray created Correct Toes, a toe-spacing device made of silicone that places toes in their normal anatomical position, helps strengthen the feet, and encourages proper blood flow to the plantar fascia, to help his patients recover.
READ THIS NEXT: How the Toes Can Impact Plantar Fasciitis
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