Wednesday, September 27, 2023
By: Rebecca Schumer, DPT, MedStar Health
Plantar Fasciitis (PF) can be a real pain in the you know what… the foot! More specifically the bottom of the foot, usually closer to the heel bone, especially when first getting out of bed in the morning. That’s the classic sign that you may be experiencing issues with your plantar fascia.
Plantar Fasciitis accounts for about 8% of running injuries and has many causes potentially coming from the back, nerve entrapment, tight posterior chain, etc. The plantar fascia gets the blame, but it’s often not the cause. So, part of treating it is also figuring out why it’s happening so we can hopefully reduce the likelihood of it coming back and minimize how long you’re dealing with this issue.
Contrary to popular belief, the actual fascial tissue cannot be stretched, but we can work the tissues around it to reduce stress on it and allow it to heal. In physical therapy, this could include functional dry needling, taping, orthotics, strengthening exercises to build a robust foot and ankle, foam rolling or soft tissue mobilization to surrounding tissues that are tight to aid in bringing blood flow to the area to stimulate a healing response.
If you know someone who has battled PF before, they’ve likely tried night splints, rocker bottom shoes, or literally anything recommended to try to get rid of it. Unfortunately, it’s hard to predict who will struggle with this for a longer duration, thus the importance of getting help more quickly. Just like other tendon issues, if it’s an acute issue, we treat that very differently than if it’s a chronic problem.
If these conservative efforts are not effective and are exhausted, there are more invasive methods like injections which can be explored with a foot & ankle specialist or podiatrist. Having PF can affect your running in different ways, some can get away with it, others can’t. It’s important to seek the opinion of a professional if you start having pain in the bottom of your foot to minimize the need for taking time off running and to appropriately plan the need to potentially cross train to allow the inflamed tissues to heal.
A couple ideas to get you going if you’re starting to experience pain in the bottom of your foot would be to try foam rolling the back side of your leg all the way from your hamstring (back of your upper thigh) down to your lower leg. When foam rolling, you want to ensure that leg is relaxed on the foam roller, and spending 30-60 seconds per area being rolled is plenty. You can also try to gently stretch the bottom of your foot by bringing your ankle upward with one hand, then extend your big toe with the other hand until you feel a gentle stretch in the bottom of your foot. Again, hold for about 30 seconds to a minute and repeat a few times, especially before getting out of bed in the morning. It’s also helpful to try some exercises to strengthen the arch of your foot. If you’re sitting in a chair with your feet flat on the floor, try lifting only your big toe up while keeping your little toes down, then vice versa. Don’t let your heels come up and don’t let your knees cave in while trying these. Go slowly, and repeat 15-20 times.
PF can be a lingering issue, and can return, so again, re-enforcing the importance of seeking the opinion of a professional to get an individualized plan to reduce the time spent with pain in the bottom of the foot.