Plantar Fasciitis:
by
Alex Mroszczyk-McDonald
 Plantar fasciitis is an irritation of the tissues surrounding the muscles and tendons in the bottom of the foot. Often caused by repeated activity with inefficient rest or increasing activity too quickly. Traditionally this occurs in a runner who's arches collapse during foot strike and/or over pronate. This repetitive flattening of the arch leads to the inflammation. Runners are most often affected but, not the only athletes who can be plagued by this injury.
Plantar f asciitis is a very frustrating injury for anyone, especially a runner, due to limited symptoms at times only to be easily re-aggravated by any activity. As a result caution is strongly advised on returning to weight bearing activity, including running.
Duration of plantar fa s ciitis and presence or absence of pain, can be important indications of when it is appropriate to return to weight bearing activities, in particular running. If you are still experiencing pain at rest, running is ill advised. Trying to run while acute inflammation is present can re-aggravate the condition and further prolong your recovery. Rest, ice and stretching are the mainstays of treatment. Patience now, will pay dividends later. Often NSAIDS, such as ibuprophen, are recommended, however, there is little conclusive evidence that suggests NSAIDS offer any benefit for soft tissue injuries.
Once you are no longer experiencing pain at rest you can gradually return to activity. Initially with gentle foot exercises that strengthen the muscles in the arch of the foot, such as gentle toe curls, marble pick ups and tapping the big toe while holding the remaining four off the ground. Begin with just a few of each exercise and gradually increase the repetitions. Also, while returning to activity it is important to continue the routine of stretching and ice.
When pain is no longer present, running can be re-incorporated with a few modifications. If you have not already done so, make sure your running shoes provide appropriate arch support as well as cushioning. A specialty running store can be very helpful if you are unsure. Commercial insoles or custom orthotics from companies such as Spenco are good options to provide necessary support. Be careful when returning to activity, re-injury can easily occur and gradual increase is strongly advise. It is imperative not to over reach your limits, as pain can diminish with warm up and activity but then can be amplified afterward. A good rule of thumb when returning to activity is not more than 50% of your previous training volume or distance. If plantar pain persists or reoccurs, physical therapy or seeing your doctor is recommended.
Plantar faciitis resolves entirely in the majority of patients within a few months. In the mean time non-weight bearing exercise, such as biking and swimming, are appropriate. The key to a healthy return to running is initial rest, with gradual return to activity along with a good dose of patience.
Editors Note: Another very helpful therapy for plantar faciitis is called Prolo therapy. Prolo therapy is the injection of dilute sugar water in the injured plantar facia. In over 80% of cases pain resolution is fast and return to activity much quicker than conservative treatments. The dilate sugar water causes the ligaments to thicken and strengthen. For more information and referral go to www.getprolo.com
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