By Bonnie Stein, M.Ed.
Plantar fasciitis is that pain in the bottom of your foot that especially hurts first thing in the morning when you try to get out of bed and stand on it, or when you get up after sitting for awhile. Do not ignore this pain. It will not just go away by itself.
The pain is caused by wounding the tough fascia connective tissue on the bottom of your foot. This band runs from your heel to the ball of your foot. It supports your arch and it transmits your weight across the bottom of the foot with each step you take.
If the plantar fascia gets bruised or over-stretched, the inflammation causes foot and heel pain. It can also get partially detached from the heel and a calcium deposit can form - a heel spur.
What Caused it?:
1. Over-pronation: Excessive rolling in of your foot and ankle with each step. This can be corrected by wearing running shoes with a medial post for extra motion control. You may also need orthotics. Start with a specialty running store where an experienced sales associate can tell you if you over-pronate. My favorite over-the-counter orthotics are made by SuperFeet. If these don't work, the next step would be custom made orthotics by a sports physician.
2. Wearing old shoes: Shoes lose their support and cushioning after 3-5 months. If your shoes are over 6 months old and you wear them regularly, they are dead. Get rid of them or you risk injury.
3. Non-supportive shoes on hard surfaces: Although racewalkers like lightweight training performance shoes or racing flats, you may need to buy shoes with a little more cushioning. Never wear racing flats if you have plantar faciitis. You can even get plantar faciitis from just standing around for long time periods on hard surfaces with non-supportive shoes. People who work in stores, restaurants, and hospitals (concrete floors) and are on their feet all day are prime candidates for plantar faciitis.
4. Tight calf muscles: You should stretch your calves every day. Aim for three times a day at least.
5. Over-use: doing too much exercise without proper recovery. You should progress gradually and increase little by little. No more than 5-10% increase in activity per week. Limit all weight bearing activity while you're trying to heal plantar faciitis.
What to do:
1. Rest: Once you have plantar fasciitis, you should back off of your walking distance or activity and not exercise through the pain. You can do non-weight bearing exercise.
2. Icing: Use an ice pack on the foot for 20 minutes after walking or any activity. Freeze two water bottles about 3/4 full of water. Roll your feet on them every day for 20 minutes. Three times a day if possible.
3. Self-Massage: Massage the foot before getting out of bed in the morning. Use long strokes from the ball down to the heel. Put on supportive shoes before you get out of bed.
4. Night splint: This device holds your foot flexed at night so that the plantar fascia doesn't tighten up and cause that horrible pain as you stretch it first thing in the morning, which can in fact re-injure it.
5. Stretch your calves every day.
6. Wear shoes with a supportive arch (not slippers or sandals), even indoors, until it is totally healed and you have no pain at all. If you walk around barefoot – you will continue to tear the healing tissue every time you step down.
7. If you try the above treatment for a month and have no relief – see a sports podiatrist. Plantar Faciitis can take 6 months to a year to heal even if you properly treat it.
Prevent it from coming back:
Once the pain and swelling have begun to subside, perform calf stretches three times a day (did I emphasize calf stretches enough?) Continue to stretch your calves to prevent recurrence of plantar fasciitis and heel spur. It's one of those injuries that you don't want to ever have again.