Injuries make it more challenging to work out, but so does a more chronic condition called plantar fasciitis. Common in athletes and non-athletes, plantar fasciitis is irritation of the band of tissue, called the plantar fascia, which extends across the bottom of your feet from your heel to your toe. It’s this band that supports your arch. Although plantar fasciitis is more common in athletes who run a lot, especially long-distance runners, it can affect almost anyone. If you’ve had plantar fasciitis in the past, you know how it can come and go, and when it rears its ugly head, it makes working out more uncomfortable, especially when you run or jump.
What Causes It?
The strong fibrous band, called plantar fascia, that gives your arch support normally stretches when you walk. Sometimes one of these bands becomes stressed due to repetitive use or when it is forced to handle too much stress. For example, being overweight or obese places added stress on these bands and increases the risk for plantar fasciitis. Repeated stress can create micro tears in the tissue and lead to pain and stiffness.
If you have plantar fasciitis, you’re probably familiar with the symptoms. Most commonly, people with this condition experience pain, stiffness and sometimes swelling in the affected heel as well as the arch of the foot when they first get up in the morning or after sitting for a while. The early morning stiffness usually gets better after walking around for a few minutes as the fascia stretches out, only to recur again later. Both prolonged sitting and intense activity usually worsen the symptoms.
If you have anatomical foot problems like high arches, very flat feet or over-pronate (feet roll inward too much) when you walk or run, you’re also at higher risk. You may be an over-pronator without being aware of it. Women are also at higher risk for plantar fasciitis for unknown reasons. Plantar fasciitis is NOT caused by a heel spur. Most people with heel spurs don’t have pain or discomfort. In contrast, plantar fasciitis can be a very painful condition in some people.
At one time, the discomfort was believed to be due to inflammation in the fascia, but this idea has since fallen out of favor. That’s why fewer orthopedists prescribe non-steroidal anti-inflammatory medications for plantar fasciitis these days.
Exercising with Plantar Fasciitis
When your heels and arches ache, exercise is more challenging. Depending upon the severity of your symptoms, you may be able to continue with your routine and shorten the duration of your workouts so you’re placing less stress on your feet until your symptoms improve. If you’re having significant discomfort and doing long workouts that involve running or jumping, modify your routine for a few weeks until the symptoms are under better control. Resistance training, circuit training that doesn’t involve jumping, spin workouts, and step training are better options until your symptoms improve. Doing daily stretching exercises also help to stretch out tight fascia.
Stretching Away the Discomfort
One of the most effective ways to reduce the discomfort of plantar fasciitis and prevent a recurrence is to stretch your calves and feet. Here’s one way to do it. Stand on a step while holding the rail, with both heels hanging off the edge of the stair. Slowly lower your heels without bending your legs until you feel a stretching sensation. Hold the stretch for 30 seconds, rest and repeat.
Another exercise you can do when you’re sitting at your desk with your shoes off is to place your feet on a tennis ball and roll the ball back and forth underneath your foot to loosen up the tight fascia. This motion helps to break down any adhesions that may be contributing to the tightness and discomfort. Ice can also help to relieve the discomfort. An alternative to a tennis ball is to freeze a plastic water bottle and roll it underneath your feet several times a day.
Some orthopedists also recommend wearing a night splint, available at durable medical equipment stores. A night splint stretches out the plantar fascia while you sleep and helps reduce early morning stiffness and pain. The downside is wearing a night splint at night is cumbersome and takes some getting used to.
Footwear
If you’re wearing old workout shoes that don’t fit properly, toss them. With plantar fasciitis, you need supportive footwear with good heel and arch support to conquer plantar fasciitis and prevent future problems. Your feet may also benefit from arch supporting insoles. If you have flat feet, you’re more likely to be an over-pronator and may benefit from special “motion control” athletic shoes that reduce over-pronation. The heel counter of the shoe you choose, the portion that touches your heel, should be firm and hold up when you apply pressure to it. The sole of the shoe should be firm but flexible and the heel cushioned for support and to absorb shock.
If you have recurrent problems with plantar fasciitis, it’s best to consult a podiatrist, orthopedist or sports medicine doctor and have them assess the biomechanics of your feet. If you have anatomical problems you may benefit from a custom orthotic you place in your shoe. Correcting biomechanical problems will help you prevent future problems. Don’t forget problems with foot biomechanics such as overpronation can change your gait and lead to knee, hip and back problems.
In the worst-case scenario, surgery can correct the problem for some people, although it should be a last resort. Another option, cortisone injections, aren’t used as widely as they once were since it’s doubtful whether inflammation is the sole cause of the pain anyway. Plus, repeated cortisone injections can cause tissue breakdown. Best to treat it naturally through stretching and correcting biomechanical problems.
The Bottom Line
Plantar fasciitis is a real “pain,” especially if you exercise. Recovering from plantar fasciitis can be slow. It may take several months of stretching exercises and modifying your routine to get complete relief, but most people do experience improvement over time.
References:
OrthoInfo. “Plantar Fasciitis and Bone Spurs” June 2010.
WebMD. “Plantar Fasciitis”
MedLine Plus, “Plantar Fasciitis”
J Athl Train. 1992; 27(1): 70, 72-75.
American Academy of Podiatric Sports Medicine. “Plantar Fasciitis: Treatment Pearls”
The Sports Injury Doctor. “Plantar Fasciitis Exercise”
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