Plantar Fasciitis: What Can I Do?

by | May 2, 2019 | Injury Q and A

“I’ve started getting a dull achy pain in the sole of my foot and back towards my heel. It doesn’t hurt all the time but bothers me when I run and walk sometimes. I know that I have a tight calf in that leg and have to wear high heels for work. What do think this is and what should I do next? Are there any exercises I could do to help?”

– Richard W.

Matt answers…

The symptoms you describe are very common among distance runners and traditionally referred to as plantar fasciitis (PF) meaning ‘inflammation of the sole of the foot’. Research has since suggested that inflammation is not the issue, nor is ‘fallen arches’ or ‘flat feet’ the cause, which may explain why many of the traditional methods used to treat PF prove unsuccessful.

Degeneration of tissue is more likely the case, with potential risk factors including excessive standing during the day, being significantly overweight, or having limited dorsiflexion (e.g. not being able to squat very far without your heels leaving the floor).

The frequent wearing of high heels you mention can lead to long-term tightening of the calves and reduced dorsiflexion. Due to the inappropriacy of the name plantar fasciitis, modern texts have renamed it Plantar Heel Pain (PHP), which is fitting as pain is most typically reported on the inside of the heel. The formation of spurs (build up of calcium deposits) is commonly seen.

Treating PHP is still a bit of a mystery but trying to ignore it is definitely not recommended. For short-term pain relief, wearing specially applied tape (the low-Dye method developed by Dr. Ralph Dye) or sleeping in a night splint can prove successful.

Stretching and foam rolling of the calf may help too and specific stretching of the plantar fascia itself is often regarded as particularly beneficial, e.g. pulling the toes back (especially the big toe) and holding for 30 seconds a few times a day.

Experimenting with shoe inserts can be a good idea too, ideally something non rigid that provides cushioning. Though inefficient arch control is not a primary cause of PHP, it can exacerbate symptoms. During rehab, avoid wearing very flat shoes as this can increase load on the Achilles tendon and likewise worsen symptoms.

As always, a visit to a professional is highly recommended before embarking on any treatment program. Good luck and let us know how it goes!

Do you have any experience of suffering from symptoms of plantar fasciitis? How did you get over it?  Whether you are a therapist, coach or runner we would love to hear from you in comments section below!


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