Running

What You Need to Know: Plantar Fasciitis

Today’s blog post is courtesy of a special guest writer and expert on the topic of Plantar Fasciitis: Rachel Zimmerman DPT.

If you’ve ever experienced pain in the bottom of your foot, or in your heel, chances are it’s Plantar Fasciitis.

There is a common misconception that this is something you have to live with, but you don’t! The following advice will help alleviate your pain and get you back on your feet.

What is Plantar Fasciitis?

To understand what this condition is, we need to break it down into parts: plantar fascia and -itis. The plantar fascia is a structure in the bottom of the foot. It is a thin, white tissue similar to a ligament that sits between the skin and the muscle and extends from the heel to the toes. It provides stability to the foot. The suffix “-itis” is a Greek term meaning inflammation. So plantar fasciitis is inflammation of this tissue in the bottom of the foot.

What are the Symptoms of Plantar Fasciitis?

Plantar fasciitis typically presents as pain in the heel, usually on the inside part of the foot. The pain can also spread along the arch and along the bottom of the foot. The pain is usually worst during the first few steps after getting out of bed in the morning but can also occur after standing or walking for long periods of time.

What Causes Plantar Fasciitis?

Plantar fasciitis has multiple causes, but one of the most common is increasing your activity level too quickly! Also, having tight calf muscles, weak foot muscles, and/or wearing improper footwear.

What do I do if I believe I have plantar fasciitis?

Avoid aggravating activities: The most important thing you can do when you have an inflammatory condition is to avoid activities that increase your pain. Figure out which activities are aggravating it and modify them as you can. This does not mean to avoid activity altogether – just find activities you can do that don’t increase your pain level. This does not have to be long term, just while you are experiencing pain.

Stretch your calves: Tight calf muscles (the gastrocnemius and soleus muscles) can contribute to inflammation in the plantar fascia. Stretch your calves by sitting with your feet out in front of you with your knees straight, and place a towel around the ball of your foot. Pull back on the towel towards you until you feel a stretch in the calf. Hold for 30 seconds and then repeat a few times. You should feel a stretch, but not pain.

Strengthen your foot muscles: There are specific muscles in your foot that help to support your arch and take stress off the plantar fascia.

   • Great toe extension: Lift big toe, leaving other 4 on the ground. Repeat for 3 sets of 10.

   • Small toe extension: Lift 4 smaller toes, leaving big toe down. Repeat for 3 sets of 10.

   • Doming: Raise the arch of your foot, keeping toes down. Repeat for 3 sets of 10.

Change your footwear: Avoid shoes that are flat as these do not support your arch and can contribute to stress on the plantar fascia. Look for shoes that have a buildup on the inside of the shoe where your arch would be. Most shoe stores will be able to help find footwear that is appropriate for your feet, whether you need a stability shoe (which has more arch support than normal) or a neutral shoe (which has arch support but not as much as a stability shoe).

Ice: You can freeze a plastic water bottle, and then roll your bare foot over the frozen water bottle. It provides massage and ice, which will decrease the inflammation and will numb the pain temporarily. Do this for a few minutes at a time at most.

Consider orthotics: There are orthotics, or inserts for your shoe, that provide more stability for your arch. You can try basic orthotics from a drugstore or consider custom orthotics. A physical therapist, podiatrist, or orthotist can help you with custom orthotics.

**If your pain does not get better, consult a physical therapist! There are many other factors that contribute to plantar fasciitis that your physical therapist may be able to assess and treat.

This blog was specially written by our friend and guest writer Rachel Zimmerman, DPT.

Rachel is clinic director at ATI Physical Therapy right here in Green Bay, WI. You can find out more about her clinic or find a location near you at ATIpt.com!

Running: Do’s & Don’ts!

Running (and walking) is an incredibly functional movement; your body is literally built for it! The cross-body movement pattern of driving the opposite arm and leg forward in unison helps improve our coordination and stability by nurturing the relationship our disparate muscles share via the muscle fascia.

What is Fascia?

Basically, Fascia is connective tissue superficial to the muscles that helps connect them to other parts of the body. It’s been described as big rubber bands that help us transfer energy during certain movement (such as the see-saw/back-and-forth type movement involved in running….left, right, left, right). But this fascia can get stuck and lose some elasticity when we don’t move it to keep it loose! Then we are stuck with this rigid strap limiting our movement, instead of a supple rubber band which allows us to move and then “snap” back in place.

For more reading and understanding of fascia check out this link below to see how unhealthy fascia can lead to low back pain
http://traineradvice.blogspot.com/2013/01/thoracolumbar-fascia-forgotten-culprit.html
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RUNNING TIPS:

DO

– Your Research! Shoes are a major factor contributing to an effective running program, especially if you’re intending to run on asphalt and/or concrete surfaces.

– Your Homework! If you’ve set your sights on an upcoming run be it a 5k, 10k, marathon or more you need to give yourself adequate time to prepare if you want to finish without injury! There are “proper” running mechanics that will help you not only land a better time, but protect your body from the repetitive stress of running. Bend your arms at 90 degrees and pump them along with the opposite leg during stride, engage your core muscles for stability to avoid excess strain on your low back throughout the run, Relax the shoulders down onto the back and don’t over-stretch your stride length – keep it comfortable and you will be able to hold a steadier pace for a longer period of time. Seek the advice of a professional for help analyzing your gait and setting up an appropriate training program to prepare for your big run.

– Prepare! Be aware of your environment! Don’t decide at the last minute to go for a run at night, through a neighborhood with no sidewalks in all black! It sounds funny, but be aware that it is VERY difficult to see runners! Wear bright colored clothing – even reflective material if running at night. Also, be mindful of WHERE you are running. If you’re trying to achieve a multiple mile run you might easily find yourself in an area of the city that is not runner friendly or safe for that matter. Run with a buddy if possible or plan and drive your route ahead of time.

– Hydrate!

DON’T

– Be a Hero! Running is one of those things people seem to think they can just pick up at any time and go-go-go! While we applaud your motivation, it’s important to approach it just like any other physical activity and ease into it to avoid injury. According to Runner’s World up to 66% of runners suffer an injury every year!!

– ALWAYS Run as FAR as you can! the 80/20 principal is widely used by many top endurance athletes. This means that 80% of their training is in the “low intensity” range (<77% max HR or breathing comfortably through the nose) and only 20% is at the moderate or higher intensity. For instance if you run 100 minutes per week, 80 of those should be in the low range, maybe 15 at moderate intensity (77 to 92% max HR, able to speak in short sentences) and 5 at high intensity (over 92% max HR and breathing as hard as you can after just a couple minutes). HAPPY TRAILS