Plantar fasciitis (PF) is a term used to describe inflammation or pain on the bottom of the foot. The plantar fascia is a taught band of tissue that holds the arch of the foot. There are also TONS of layers of muscles on the bottom of the foot that can give pain as well meaning the pain generator is not just the plantar fascia, it can be from muscles as well.
The pain can come in a few different forms – sometimes it’s pain on the heel, sometimes it’s pain on the arch. There are a few other things that “foot pain” could be, but there are a few classic signs of PF:
- Pain that is worse with the first few steps out of bed in the morning
- Pain after a longer time standing, walking, or running
- Pain that seems pin pointed on the bottom of the foot and is sensitive to the touch.
None of the above can rule in or rule out the diagnosis, but many people who come see us for PF pain present with some of the above. The main issue with PF is that it gets stressed every day because we are upright beings and we constantly have to put pressure on the spot that hurts. PF tends also to hang around way too long and when treated improperly, can lead to a very long bout of unnecessary foot pain.
Most people get a flare up from doing a bit more of something that they aren’t use to. How can you get it?
- Running longer
- More hills/inclines
- A change in shoes
- A significant change in terrain (I got it when I went hiking for the first time last season and wore running shoes)
- Doing more of the same activity that you aren’t used to
- Doing more walking in different shoes (walking around the city for the day in flats or flip flips if you aren’t used to it
The most common ways that people manage this type of foot pain is with ice, stretching, rolling the bottom of their foot on a ball, anti-inflammatory medications, and orthotics. While all of those play a role in the recovery process, there are some other things that should be focused on to really make the most out of your rehab.
The initial stage (0-72 hours)…
Gentle stretching, ice, and normal walking around, etc is appropriate especially if it is super irritable. But this really should only last as the sole type of treatment for the first few days of a flare-up. Yes… only for the first few DAYS! This means that more can be done that is much more beneficial if this has been going on for longer than a few days.
Anything but the initial stage (past 48-72 hours)…
You can continue to stretch, ice, ball massage, etc but there is a key component to PF pain that most people don’t address. This is the concept of adding stress to the foot. This would seem counterintuitive, right? Why would we want to stress an already overworked and stressed area of the body? That is actually how rehab works… in many cases our body responds best to adding an appropriate amount of strain to actually get it back to normal. Sometimes, that initial addition of strain gets the area a bit cranky, but as it is repeated that crankiness actually subsides.
This explanation was very brief for the purposes of this article so I want you to keep in mind that every pain experience is different and involve many other factors that affect the treatment outcome. This information can at least set the stage on the idea that there is more to PF pain than ice massage with a frozen water bottle and time off from the treadmill.
Here are some of our go-to PF pain exercises!
- Toes elevated heel raise – This exercise targets the plantar fascia directly to give a combined load stress and stretch.
- Single leg heel raise (modified) – This exercise is imperative for ALL RUNNERS to be performing on the regular. Single leg heel raise strength is incredibly important for runners – you are NEVER on two feet and your calves do a ton of work. They need isolated training and it needs to be hard enough to make gainz. This is a modified version for someone with irritable PF pain, a progression would be to loose the bench and perform with hand-held assist on a chair or wall. This exercise not only strengthens the calves but it also works on the foot muscles as well which can help build and repair the irritated foot!
- Double leg weighted heel raises – This is another staple in anyone’s foot pain program. Double leg her raises work to build up the calf muscles which, as stated above can help build and support the foot as well. The double leg feature allows both calves to work, adding load can help make it challenging enough to make changes.
Lastly… Are you more of a visual / auditory learner? I put a little video together explaining the exercise in the first video! How to help your foot pain
Were you intrigued by this an have more questions? Please reach out!