Plantar Fasciitis: Load it, Don’t Roll it
Unfortunately, this is one I know all too well. I dealt with plantar fasciitis for more than a year while running in college and never received any relief from the standard calf stretching, and rolling and icing the fascia. This is usually clinician’s go to across the healthcare field. While this may help with a little bit with pain, it’s never going to cure plantar fasciitis.
What causes it?
If you’ve had plantar fasciitis, think back to the day before you got it what changed from that day to the next? Did your calf magically become too tight overnight? Of course not, it had the same tightness that it’s had forever. What likely happened is that you stressed your fascia in a way that it was not ready to be stressed. Whether that’s from too much change in training, either in intensity or duration or a drastic change to shoes, your body wasn’t ready for it.
Focus of Treatment Standpoint
So where does that leave us from a treatment standpoint? Well if the root cause is that the plantar fascia couldn’t handle what we were throwing at it, then the treatment should include something to build the fascia’s resilience! This is why I will never give my patients the treatments I was given in college, because none of them achieve this goal. To know how to adequately load the fascia we have to look at it’s anatomy.
Looking at the anatomy of the plantar fascia we can see it goes from our heel which is where most of our pain will occur and attaches into our toes.. This means that we have to involve the toes if we want to affect the fascia. The easiest way to do this is to elevate our toes on a towel roll and push into it as we lift our heel.
We are going to treat plantar fascia very similar to tendinopathy‘s, in that, to manage pain we want to work on holding this position. And once our pain has subsided we need to begin adding slow active movements with the same set up, through a full range of motion progressively load the plantar fascia.
Additionally, using the idea of involving the toes we should be ensuring that he have full toe mobility. A lot of runners lack toe extension and coordination and don’t know it. This is obviously important when you think that our sport is based around our foot. To do this we can interlock our fingers between our toes (gross, I know) and push them back. We can easily see if our toes are drifting inward, their way of cheating, when going into extension and if they are limited compared to the other side. If there’s a restriction or difference when we need to overpressure our toes, either with our hands or on the ground.
On top of all this we also need to appropriately dose our training. Consistent and slow build up in training is the biggest thing we can do to prevent this in the first place. A temporary decrease or stoppage of training may be needed to help things calm down in very irritable cases. Stopping is a last resort and does not mean that we are resting completely. We still need to be continuing to load the fascia or we are risking detraining and being right back to where we were.
What happened to my journey with plantar fasciitis? It’s a result I don’t want for anyone. It played a roll in burnout that eventually lead to me walking away from running for over 7 years. 7 years that took me from an elite runner to unable to run a mile. Nothing I want for anyone to experience, especially at the hand of something completely avoidable and treatable.
Dealing with plantar fascitis?
This content is intended for patient education, not clinicians. If you would like references regarding the information provided, please email strideptco@gmail.com.