It’s running season, and in the interest of making sure you can run your best this year, the team at Capitol Rehab of Arlington is putting on its running doc hat to answer your frequent questions. First question up: What is the fastest way to get rid of plantar fasciitis?
Plantar fasciitis is pain, basically anywhere along the bottom of the foot. The pain usually comes on gradually and may be worse in the morning. It is important to remember that plantar fasciitis isn’t a mystery at all, in fact it is preventable and predictable!
If you were to look in any anatomy book at the foot, you would notice that there are several muscles. The first thing you would notice is that the largest muscles of the foot tend to be more square in shape not long and slender. Square muscles are designed to primarily provide stability while long, slender muscles provide torque and movement. Their size and shape of a muscle dictates their function and purpose of that muscle. For example, CORE MUSCLES are square and broad, like the quadratus lumborum and obliques, while the hamstrings and hip flexors are long slender muscles that produce movement.
The second thing you would appreciate is the large number of bones that make up the foot and ankle. When two bones come in contact, those two bones form a joint. The foot has many joints that come in contact with one another, meaning there are many, many joints in the foot and ankle.
OK, now that we have gone over the anatomy, lets talk about what happens when the anatomy is disrupted.
First, we see that most athletes do not train for balance. Balance is a great indicator of how well the STABILIZING muscles of the foot are working. Athletes with poor balance have poor foot stabilization. Poor foot stabilization means those stabilizing muscles are easily challenged and eventually overworked in the runner. When the stabilizers become overworked, they become irritated and the pain will present as plantar fasciitis.
The second challenge, and by far the more common presentation, is when one or more of the joints in the foot become locked out of place. Joints are meant to move, but they frequently move excessively and can get stuck out of place. Occasionally, the joint can shift out of place due to a sudden occurrence, e.g., taking a bad step or stepping on an object that traumatizes the joint, but more commonly the joint dysfunction happens slowly overtime. Poor footwear, poor or no orthotics, and weak muscles of the foot can all contribute to a gradual shift and eventual dysfunction of the joints in the feet.
There are a couple of factors that make plantar fasciitis challenging. The first is understanding that the plantar fascia is a “plastic,” not an “elastic” structure. This means that when the sole of the foot is stretched too much for too long, it becomes permanently deformed. When the tissue becomes deformed, it may be difficult to provide a long term solution without using an orthotic, which would support the foot and control for excess movement.
In most athletes, the sole of the foot slowly changes or “deforms” over time, regardless of health or injury. This explains the increased need for an athletic orthotic as a part of the long-term treatment of plantar fasciitis.
Prevention of Plantar Fasciitis
- Make certain to have movement of the foot joints evaluated by an expert. A very good chiropractor or physical therapist can make this assessment very quickly.
- Work on balance training and exercises. Here’s our video exercise, appropriately called the Running Man, to help with balance.
- Improve ankle mobility and calf flexibility. There is a lot of current research that shows the relationship between good ankle movement and decreased injuries of the lower extremity.
- Get properly fitted by a shoe expert for running and training shoes. We recommend our friends at Pacers Running Stores, of course, to help with the right shoes.
- Get assessed for running orthotics. This is a necessary step for many runners, especially as we age.
Treatment of Plantar Fasciitis
- The first step must be to restore normal movement of the foot joints. We see more cases of “failed” plantar fasciitis because this step is commonly overlooked by health care providers.
- Train the balance mechanisms of the foot.
- Increase the length of the muscles of the calf and improve ankle mobility.
- Get evaluated or re-evaluated by a shoe expert to make certain you athletic wear is best for you.
- Consider an athletic orthotic. Start with an over-the-counter brand like Super Feet, but understand that the over-the-counter styles only correct approximately 15-20 percent of plantar fasciitis problems. The other 80-85 percent need to be custom-fitted for a specific design.
If you have any additional question do not hesitate to contact us at 703-527-5492 or check out our website for more information.