Plantar Fasciitis- Do I just need insoles?
Updated: May 9, 2021
If you’re a runner, and maybe even if you aren't, you have likely at some point in your running career heard about the dreaded "plantar fasciitis", or maybe you’ve been unfortunate enough to experience it. And whether you’ve had it or you’re just trying to avoid it, you’ve probably had everyone and their mother telling you what they did to manage it when they had it or what they do to attempt to avoid it, including new shoes, super expensive orthotics, a change in your strike pattern, and the likes.
You’ve even probably been warned that you may have a heel spur that’s causing your planter fasciitis and the pain that you’re experiencing. So today I would like to debunk a few of the common myths within the running community about plantar fasciitis and teach you what it actually is and what you can do to treat it and prevent it.
Plantar fasciitis, is an inflammatory condition due to overuse or over stress of the planter fascia. For everyone, that sort of overuse looks very different, and can be anything from going from never having run before to trying to run for the first time, to even being a trained athlete who is just trying to increase their mileage to quickly. The body is very much adaptable, but it can only adapt at a certain rate and we have to be respectful of that capability.
It is also important to know your anatomy when examining the planter fascia and it’s frequent irritation. The planter fascia is a layer of tissue on the bottom part of the foot that attaches to both the bones at the ball of the foot and to the heel bone. Often times the development of a heel spur comes from constant stress being placed on the planter fascia and instead of the planter fascia pulling apart from the heel bone, the bone will adapt and grow out to meet the planter fascia, lengthening the distance between the heel and the ball of the foot, and taking tension off of the facia.
However this bone growth can cause irritation, but there are hundreds of thousands of people walking around in the world right now with what an x-ray would show as a heel spur, who have absolutely no pain. So it is not an excuse or reason for your body to be experiencing pain, and the pain from the heel spur can in fact be eliminated without eliminating the heel spur itself. In many cases the heel spur never develops and the tension on the fascia develops for another reason.
The heel bone as it is naturally oriented is essentially a lever between the planter fascia and the Achilles tendon, which attaches to the opposite upper side of the heel bone. The Achilles tendon then attaches into the entirety of the Gastroc/soleus complex of muscles, a.k.a. the calf muscle. Because of the mechanism of running from heel strike to toe off, the entirety of the calf muscle/Achilles tendon/heel bone/plantar fascial System is under various amounts, including some very high amounts of tension at different times, making running one of the highest stress situations for the planter fascia aside from jumping. And if you really think about it running is just jumping from one foot to another, so they are basically the same. Needless to say, since there are so many different factors playing a role in the tension being placed on the planter fascia, there are lots of things that would need to be evaluated and considered when managing someone’s planter fascia. This is why, despite your new shoes, change in training intensity, expensive Insoles, and whatever other recommendations have been given to you, your pain may subside temporarily, but often time it returns, due to the fact that the root cause of the problem was never addressed. And that is where I come in.
Physical therapists are especially equipped with the skills and knowledge to properly and thoroughly evaluate the situation in a runners lower extremity, allowing us to not only alleviate the pain, but to ultimately fix the bio mechanical problem that predisposed the athlete to developing this painful condition in the first place. We help enable athletes to rid their body of its asymmetrical and balances, and teach the clients how to manage their body‘s natural tendencies for a lifetime of long healthy running. In the meantime here are a few commonly prescribed exercises that can help you begin to alleviate some of the pain from plantar fasciitis, or can protect you from high-risk situations that may cause you to develop it. If you’re struggling with plantar fasciitis, or if you know someone who is, or if you would like to learn more about my preventative injury programming for runners, please feel free to give me a call or reach out and I would love to chat with you!