Plantar fasciitis can be one of the most frustrating injuries you can encounter during your running career. It usually appears out of nowhere and is characterized by a deep ache or sharp pain under your heel and along the arch of the foot. It can take many months or even years for the involved tissues to heal. If you have been diagnosed with this condition, conventional wisdom is to stop training and rest until the pain goes away. However, is this really the best way to treat plantar fasciitis? Can you continue training and still get rid of heel pain?
WHAT IS PLANTAR FASCITIS AND WHAT CAUSES THIS CONDITION?
Plantar fasciitis is a repetitive strain injury that involves inflammation and degeneration of a plantar fascia – a thick band of connective tissue that runs across the bottom side of your foot and connects heel bone (calcaneus) to your toes. Runners are at higher risk for developing this condition, especially if you are overweight and have to stand for a living (e.g. cashiers). Most runners who develop heel pain are usually the ones who start increasing mileage and intensity abruptly. In addition, any of the following factors can contribute and increase the risk of plantar fasciitis:
Contrary to previous recommendations, you may be able to continue running while treating your plantar fasciitis. Most recent evidence is showing that stress from exercise is required to stimulate the healing response of the plantar fascia. The goal of the rehabilitation program is to get plantar fascia and foot muscles stronger and more resilient. However, this does not mean that you can continue running at the current intensity and mileage. We need to decrease one of the two or both, in order to let the fascia heal. Too much intensity/volume and we cause further injury, but too low intensity/volume and structures in the foot get weaker and more susceptible to further injury. So how do we go about finding this optimal level of running intensity/mileage and what kind of exercise should we be doing to strengthen the foot?
Best way to go about finding your optimal level of exercise is to listen to your body and rate the pain/discomfort on a 1-10 point scale, with 10 being the most excruciating pain you have ever experienced. Use the following guidelines:
Below is the sample of exercises that will help strengthen the foot and loosen up the tight structures that might contribute to heel pain:
1. Foot Rolling
Foot muscle strengthening
Toe elevated heel raises
Plantar fasciitis does not react well to prolonged rest. Continuing to run and perform the strengthening exercises will trigger the natural healing response in the plantar fascia. However, doing too much will create the opposite effect and create further injury. Try to find the optimal dose of exercise and avoid speed and hill training until your pain subsides.