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Plantar Fascitis - or Runner's Heel
Plantar fascitis basically refers to the plantar or bottom surface of the foot and fascia refers to a band of tissue that runs from the base of the heel to the ball of the foot. The "itis" part of it means it is inflammed. So the full definition is an inflammation of the fascia on the bottom of the foot. Think of the plantar fascia as the string on a bow. Just like the string keeps the wooden bow bent into a curve so does the tension in the plantar fascia keep a curve or "arch" in our foot. Don't have much of an arch you say, it doesn't matter you still have plantar fascia that is under tension otherwise your foot would be a lot less functional.
When we run (or walk) the plantar fascia comes under tension, especially when we have our foot in the take-off position. Try bending all of your toes back and notice how the tissue on the bottom of your foot becomes taut. This is your plantar fascia.
So how do you know you have plantar fascitis? Here are a few classic signs.
1. Pain in the heel (or arch) with stepping down on your foot when you first get out
of bed in the morning.
2. Pain in the heel (or arch) with putting weight on your foot after prolonged sitting (work, car)
3. Tenderness/pain with pressing on bottom of the heel especially on the inner side.
(sometimes the tenderness may be felt in the arch rather than at the heel)
| Example of overpronation |
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Now the next question to ask is why did I get it? This can be fairly complex but lets look at the most likely reasons. One of the most likely is that an excessive amount of pronation is present. Pronation or an excessive amount of inward motion of the foot during walking or especially running causes increased stretch on the plantar fascia. This little bit of extra stretch done over and over with each foot strike can irritate the fascia to the point of inflammation. Similarly, a shoe that does not correct for excessive pronation will also help bring on this problem. Therefore, a simple step to take would be to make sure the shoes you walk/run in provide you with stability you need. This is where a knowledgeable running shoe store ( Phidippides ) with experienced sales people is a must.
The other reasons that may cause plantar fascitis involve poor running form and/or mechanics.
How you land and take-off during running (and to some extent walking) determine not only how much pronation occurs but also how long pronation is held. Either too much pronation, or pronation held too long are problems that can cause and contribute to plantar fascitis. The "too much" aspect of pronation is similar to going to the gym and doing too much weight training. You'll be sore or injured the next day. The "too long" aspect of pronation would be like playing "hot potato". Let go of the potato quickly and nothing happens. Hold it too long and you'll burn your hand.
What we do at our office for plantar fascitis is first do an exam to evaluate if the injury is specifically plantar fascitis or something else. Once we know it truly is plantar fascitis we proceed to treat it to reduce the inflammation and pain, tape it to reduce the amount of pronation being done, and instruct in optimal running form so that both the amount and the lenght of time pronation is held is at the optimal level.
Happy Running....Jeff
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