Many runners have experienced plantar fasciitis, or know someone who has suffered from this common injury; there are approximately 2-3 million cases per year in the United States. The good news is that plantar fasciitis typically responds well to treatment, and runners and exercisers often can carry on with their routines.
Plantar fasciitis is inflammation of the thick ligament that connects the heel bone to the toes and that supports the arch of the foot. A single, specific cause is unknown; however, the condition is due to straining this ligament and resultant tiny tears that may come from:
- Feet rolling inward (excessive pronation)
- High arches or flat feet
- Tight calves or Achilles tendons
- Standing, walking or running for long periods on hard surfaces
- Shoes that don’t fit or don’t offer adequate support
- Being overweight or obese
Runners are more likely to get plantar fasciitis if they abruptly increase mileage or intensity, run on steep hills or wear running shoes that lack good arch support or cushioning.
The most common symptom is heel pain, particularly in the morning when first putting weight on the feet, or after you have been sitting for a long time. Also, pain can get worse when you climb stairs or stand on your toes. Pain might occur at the beginning of exercise and go away as exercise continues, but returns when the workout is completed.
Plantar fasciitis occurs gradually, and typically the heel pain gets worse over time. You may compensate by walking differently, which can cause other issues with the foot, knee, hip or back. Pain eventually may accompany any weight-bearing activity. And with continued stress, a heel spur may form, which is a calcium deposit that can cause additional pain.
Treating and Preventing Plantar Fasciitis
First, try resting and icing your heel. If possible, stop or reduce activities that cause the pain, such as running, high-impact exercise, or standing for a long time. Substitute different workouts that don’t put significant pressure on your heels.
Check out your shoes as well, and ensure that they have good arch support and well-cushioned soles. You may need to replace them. Or try over-the-counter heel cups or orthotics to cushion and support your heel.
If the pain goes away, you can try the activities again that previously caused the discomfort and assess if you can safely resume pain-free. Don’t try to push through the pain, or you may cause a more serious injury.
If you’ve tried rest, ice, over-the-counter pain medicine and heel supports, and your pain persists for more than 1-2 weeks, see a podiatrist, orthopedist or sports medicine specialist for an exam and diagnosis.
In addition to rest, anti-inflammatories, and wearing supportive shoes all the time, treatment often includes custom orthotics that support your heel. Night splints can stretch the plantar fascia and Achilles tendons. Specific toe and calf stretches may help as well, along with strengthening exercises to stabilize the ankle and physical therapy to address biomechanical issues. Cortisone or Botox shots can provide pain relief, and in very rare cases, surgery may be necessary to release the plantar fascia.
The healing process can take a few months to a year, but consistent treatment often is effective. According to the American Academy of Orthopedic Surgeons, more than 90% of patients with plantar fasciitis will improve within 10 months of starting simple treatment methods.
To prevent plantar fasciitis, always wear shoes with good arch support (even when getting out of bed), replace athletic shoes every few months, maintain a healthy weight, alternate high-impact activities with lower-impact exercise and stretch your Achilles tendon and calves regularly.