Plantar Fasciitis in Runners
What is it?
Plantar fasciitis is an inflammation and irritation of the band of tissue on the bottom of the foot called the plantar fascia. It, along with bones, ligaments and muscles help support the foot.
Symptoms of plantar fasciitis?
The location of pain in plantar fasciitis can be at the heel, but most often is in the arch of your foot.
Usually people with plantar fasciitis say that their foot hurts when they take their first step after not moving around for a while. This could be first thing in the morning, after sitting/laying on the couch for awhile or any other instance where you aren’t putting pressure on your foot for a while.
This happens because when you stand and walk your plantar fascia is tight and taut, like it’s supposed to be so it can support your arch from collapsing. When you’re not putting pressure and weight through your foot the plantar fascia is relaxed.
The pain and discomfort in the foot tends to go away after the foot as adjusted to the pressure and movement so after walking around for a bit your foot tends to feel better.
Think of it like putting on a tight pair of pants, like skinny jeans that have just been washed. At first it’s a bit uncomfortable to sit and move around in them. But as you move around the threads of the jeans loosen up and they’re more comfortable.
Who gets it?
Anybody can get plantar fasciitis. It typically happens to women in their 40s and any runner. Plantar fasciitis, like other acute inflammatory conditions of the bones, muscles and ligaments happen from overdoing it. An example would be a sedentary person who goes on a 2 hour hike, or a runner who has taken a break and then goes and runs a 5k race.
Why do runners get plantar fasciitis?
Runners are prone to plantar fasciitis when they do too much too soon. This could be ramping up their mileage too aggressively, or running faster than usual, or both.
The biggest mistake runners make when they get plantar fasciitis
Unfortunately many runners make their plantar fasciitis worse without even knowing it. And that’s because when they get plantar fasciitis they rest too much.
Wait, what???
Yes. You read that correctly. Plantar fasciitis gets worse if you rest too much.
This is because when you take a few weeks off to rest your foot feels better, so you get a false sense that the problem has gone away… so you go out and run because you finally can. And that aggravates and worsens plantar fasciitis.
How do I treat it?
The best way to treat plantar fasciitis is to find a happy balance between resting enough, but not too much, and doing enough, but not too much. So you do want to rest… but instead of complete bed rest do active rest.
Active rest could mean you’re doing another activity besides running, like walking, swimming or biking. Or it could mean you’re still running, just not as far nor as fast as before. Tone it way down. The slower the better. And the distance you run can be figured out with a simple test that takes 5-10 minutes.
Other things you may consider to treat plantar fasciitis:
Strength exercises: Strength exercises in the short term don’t work to heal plantar fasciitis, they can in the long run, though. So while you’re still actively having pain from plantar fasciitis: you may need to hold off on the strength exercises because strength exercises as more stress and pressure to the tissue, and in the early stages it needs to not over do it… because that’s what caused this problem in the first place. Strength exercises are good when the pain and inflammation are no longer there so you can have stronger muscles that will help support the foot so your plantar fascia doesn’t have to do all the work.
Training plans: The best training plan to prevent plantar fasciitis in the first place is one that follows the 10% rule. And the best training plan to treat plantar fasciitis is one that follows 10PEFT (it’s the 10% rule on steroids).
Rest and recovery: As I mentioned above rest is important. Rest in the case of healing running injuries comes in the form of active rest: don’t do complete rest. Keep doing activities that are sub-threshold pain levels… meaning you do enough to not provoke the pain. Don’t poke the bear, but don’t hibernate either.
Other tactics to do to help pain and inflammation in the early stages are ice baths for 3-5 minutes (just the foot needs to be in the bath), or if your body likes heat better get in a hot epsom salt bath for 20 minutes. Continuing these techniques as your working out for a month (or as part of your regular routine for life) helps keep pain and inflammation low or nonexistent.
Shoes: Many runners think their shoes caused their plantar fasciitis. It’s usually not the shoes’ fault… maybe you did get new shoes, but it wasn’t the shoes that caused the problem… it was how far you trained on new shoes from the get go. Many runners will buy new shoes, even the exact same ones they’ve been wearing, mid training cycle so their first few runs are 3 miles, 5 miles and then a 10 mile long run… Distances like that are meant for new-ish shoes, but not brand new shoes.
What’s better is when you’re starting off on a training plan check the total mileage you’ll be going through for that training cycle and get shoes accordingly. If you’re going to do 500 miles in that training cycle you may only need 1 pair of shoes and you’ll buy a new pair at the end of the cycle. If you’re going to be doing 1000 miles you need to rotate 2-3 pairs of shoes, and add a pair of shoes for every 300-500 miles. This way you’re never in the middle of a training cycle switching to new shoes… instead you’ll have new shoes during the shorter runs in the beginning of a training plan.
Stretching: Stretching can be helpful when done in the right amount. Just like with rest and strength training; you want to find a balance between doing enough but not too much. In the early days of plantar fasciitis it’ll feel better to massage the area instead of stretching it. Stretching, like strength training, is more beneficial in the long run, than short term, so you should wait until the pain is significantly lower before you start stretching the plantar fascia.
Nutrition: Proper nutrition is helpful because it can help heal the microtears that happened in the plantar fascia. Adding in extra protein, the building blocks of muscle tissue, and collagen peptides, the building blocks of connective tissue, can help your body heal the area in the right timeline. And eating a balance of carbs and fats, in addition to the protein, helps give your whole body the nutrients it needs so it has all the resources it needs to heal. If you’re undernourished your body is going to prioritize basic daily functions over healing injured tissue, so being undernourished actually makes your body stay injured.
Can it come back?
Yes.
Plantar fasciitis can, and will, come back, if you don’t treat it right from the beginning. The best thing you can do to treat it and prevent it is to look at your training plan and not over do it.
Find a training plan that follows 10PEFT if you’re already battling plantar fasciitis, and go back to the beginning of the training plan if you need to. If you’re not sure what to do find the book a call button at the top or bottom of this page for a free call to see if the program and plan I guide my clients through would help you.
