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3 May, 2018

Fasciitis plantar, the injury most feared by runners

Do you know the most frequent injuries in running? Did you know that fasciitis plantar represents 8% of runners’ injuries?
After “runner’s knee” and “iliotibial band”, it is the third most common injury of athletes (*) and can also affect sedentary people who spend a lot of time standing, especially women who regularly wear high-heel shoes.

Beyond the statistical data, if it is one of the most-feared injuries by runners this is due to the serious bother it causes: intense, stabbing pain, in the heel and on the sole, which can limit not only doing sports but also all our everyday life. Furthermore, recovering from a fasciitis plantar requires time (patience), especially if we do not begin to take measures as from the first symptoms.

For all the above, in this article we deal with what fasciitis plantar is, how to detect it, risk factors and what we can do to prevent it.

What is fasciitis plantar?

Fasciitis plantar is the inflammation of the fascia plantar: a strip of elastic tissue that goes from the calcaneus (the bone that forms the Achilles heel) to the metatarsal area (below the toes).

The fascia plantar has important biomechanical functions on walking and running: it helps maintain the plantar arch, is responsible for absorbing and cushioning the energy produced on the impact with the ground, avoids flat feet and favours the impulse from the ground…

The origin of the inflammation is not usually a specific blow but repetitive micro-traumatisms due to habitual work or sport.

Before any injury you must see a doctor or specialist health professional.

How do we detect a fasciitis plantar?

The main symptom is acute pain on the sole of the foot, especially on the inner area of the heel (where the fascia plantar is positioned). The pain is more acute on doing exercises that require a greater load on this zone and in the mornings (due to stiffness and shortening of the fascia during the night).

Although initially we can continue maintaining sporting activity, it is important to take measures from the first moment in order to loosen the fascia since otherwise it is highly probable that the injury gets worse and eventually conditions not only our training but also our daily life. The sooner we begin the treatment, the better the results will be in the short and medium term.

For being a very common injury among runners, sometimes it is attributed to any pain in the foot or heel. It is important to visit a health professional for a correct diagnosis.

Treatment for fasciitis plantar

Another difficulty with fasciitis plantar is that we often focus more on solving the symptoms (the inflammation) than the cause of the problem, which means that the injury may recur. We should be aware that, beyond alleviating the pain present (with ice, anti-inflammatories, rest, physiotherapy treatments…), we should work in order to decrease the tension produced in the fascia plantar and avoid relapses when we return to our regular activity.

First of all… exercises to alleviate the symptoms of fasciitis plantar

There are a great many exercises we can do at home to lessen the pain, help loosen the fascia plantar and strengthen the foot muscles. Below we suggest some of them:

  1. Barefoot, roll a ball or a tin/bottle along the ground with the sole of the foot (better to place a towel first, in order not to slip easily). If the tin or bottle is at a low temperature, better, in order to make the most of the analgesic and anti-inflammatory effect of the cold. You can do the exercise standing or seated, placing some pressure on the cylindrical item in order to stretch the plantar structures better. We recommend doing this for 5 minutes with each foot.
  2. Sitting on the floor, with the legs stretched out, place an elastic band or towel on the forefoot and hold the ends with your hands. Stretch in order to bring the point of the foot towards you, maintaining the knee stretched. You can repeat the exercise 10-15 times with each foot, doing 3 or 4 series.
  3. Spread the towel over the floor and, seated, try to pick it up and/or drag it with your foot towards you. Doing this strengthens the structures of the foot and contributes to supporting the plantar arch.
  4. Stand on tiptoes, rising as much as possible, and slowly return. You can do 3 series of 10 repetitions. This will help you strengthen the tendons of the heel and the shins.
  5. On the edge of a link or a bench, support the toes and leave the heels hanging. Let the heels drop as much as possible and raise them again slowly to recover the initial position. Do 3 series of 10 repetitions.

 

The most important thing… know the causes of the fasciitis plantar for prevention

Diverse factors may make you more prone to suffer fasciitis plantar:

  • Poor running technique.
  • Flat or excessively arched feet (high arches).
  • Deficient adhesion of the plantar arch or the heel.
  • Overload on the foot (over-training, overweight…).
  • Weakness of the foot muscles.

 
Taking all the above into account, we can work on different areas to prevent fasciitis plantar:

  • Use insoles to loosen the fascia zone and alter the distribution of forces, during sporting activities but also in everyday life. The insoles, if they are ergonomic, can also help strengthen the adhesion of the plantar arch.
  • Train and strengthen the heel and foot muscles in particular, improving the mobility of this area.
  • Do stretching exercises of the muscles around the foot and Achilles heel.
  • Vary training and respect the recovery times to avoid overtraining.
  • Control overweight.
  • Use adequate footwear and avoid too many surfaces.

 
Beyond fasciitis plantar, if you want to take care of your ankles, knees and hips… take a look at our article “How to take care of the joints when running”.

 

 

(*) Data taken from the study A retrospective case-control analysis of 2002 running injuries. Allan McGavin Sports Medicine Centre (AMSMC) at the University of British Columbia.