Plantar Fasciitis (PF) is a very common injury for runners as well as other athletes and non-athletes. It is a thickening, tightness and, at times, inflammation of the fascia on the bottom of the foot. It tends to have a focal point of tenderness at the medial aspect of the Calcaneous (or heel bone). What makes this injury so unpleasant is that you have to walk and run on it.
Causes and Considerations
How a person walks or runs is an important consideration in healing Plantar Fasciitis. Often, but not always, there is a heel strike in walking that is a product of an anterior pelvic tilt (you will see the pelvis tipped forward and an exaggerated curve in the low back). With the anterior pelvic tilt, the hips are already flexed and so the hip flexor is in a state of contraction at rest. When walking or running instead of getting stride length from hip flexion, the quad is fired in the swing phase to get stride length from hyper-extension at the knee.
I have found that people who are vulnerable to problems with their feet have often walked with this heel striking pattern for most of their lives, and so the muscles and other connective tissue in the bottom of the feet is weakened.
Runner with Plantar pain demonstrates her heel strike gait pattern
When walking and running the anterior pelvis coupled with the extended knee, drives the heel into the ground ahead of the body resulting in a host of problems all the way up the chain. Even when the anterior pelvis isn’t a contributing factor, you will see:
- Weakness and lack of flexibility in the muscles of the ankles and feet.
- Fascial tightness in back of the legs and foot.
- Increased muscle tension, tightness, around the pelvis and low back.
- Decreased mobility of the upper and lower torso.
- Compensations and substitutions in power production.
With the decreased movement and flexibility the core is functionally compromised limiting the power that should be generated by the large prime movers of the trunk and pelvis. Peripheral muscles of the legs take up the slack, which results in further alteration of the natural positioning and function of the foot.
In the foot and ankle this can produce different kinds of injuries* depending on a persons particular compensations and vulnerabilities. The injury will usually appear when there is some change from your normal routine, most often “too much too soon” of speed or distance or terrain changes, etc. Stretch and strength demands increase too quickly, and the result is pain.
Healing Plantar Fasciitis
Good Focuses to have while running:
- Be sure that joints and areas above the ankle and foot are relaxed and moving normally.
- Shorten the stride, relax the ankle and let the foot dangle (as if hanging loosely off the leg), move from the core and more proximal joints so that you are not asking the muscles of the ankle and foot to act as prime movers.
- Lighter and smoother on your feet, allowing for a soft heel-toe transition.
- Using momentum and not muscle force.
Other helpful practices and methods:
- Always relax slowly onto the foot when getting up in the morning or when having sat for a long time. Ease into weight bearing before walking and relax down into your feet (you want to avoid hobbling and getting more contracted as a reaction to the sharpness of the pain you are feeling). Putting on a sandal or shoe can help.
- Massage or roll your foot on a golf ball.
- Contracting and relaxing the foot, crunching up a towel with your toes.
- Orthotics can help sometimes, but that could be at the expense of failing to address the causes, and possibly further weakening the foot and other supportive structures.
Visit Rehabilitation Coaching / Recovery Running to see how Radiant Running can help you get past your injury.
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* The injury short list includes: Plantar Fasciitis, heel pain, arch pain, Morton’s Neuroma, Posterior Tibialis tendonitis, pain in the ball of the foot, pain on the top of the foot, Jogger’s Foot. There are specific focuses that can be used to help heal specific injuries. Contact Douglas for more information.