A Little More Each Day

One working mama learning to run & to maintain my 100+ pound weight loss!

Plantar Fasciitis, AKA Why I sometimes hobble out of bed in the morning!

on September 9, 2013

The only running related pain I’ve had to deal with *Seriously knocking on wood here* has been a little bit of plantar fasciitis, which I’d had trouble with occasionally pre-running as well. On mornings after I run outside, those first steps out of bed in the morning are always killer! I’ve done some looking into the issue and thought that the things I’ve learned might be helpful for someone else.

Disclaimer: I am not a sports medicine doc and this should in no way replace evaluation and treatment by your physician/podiatrist/etc.

Plantar fascia is a thick band of tissue that runs under your foot, between the bones that make up your heel and the ball of the foot. It’s very thick and strong to help stabilize your foot, but can get irritated for lots of reasons. When it gets irritated, it is referred to as plantar fasciitis. Plantar fasciitis is one of the most common causes of foot pain in adults in the US. It typically presents with pain that is worse when you first bear weight in the morning and gradually gets better throughout the day. It can be in one or both feet and usually shows up in people between 40 and 60 years old, although it can show up earlier in runners and dancers. It is typically diagnosed based on the history of pain in the morning and the pain can be reproduced if someone presses on your plantar fascia. There aren’t labs that are usually helpful in diagnosing this condition, but x-rays may be done to rule out other causes of foot pain (like stress fractures, etc). This isn’t an area with a lot of good scientific research, but there are certainly lots of anecdotal things you can find about risk factors and treatments.

Proposed risk factors include: obesity, wearing non-supportive shoes, prolong standing or jumping, flat feet or reduced ankle mobility. In runners, specific risk factors seem to be excessive training, particularly a sudden increase in distance, faulty shoes and/or unyielding surfaces. For me, I know that mine is worse after I run on sidewalks and not as much of an issue after treadmill / asphalt runs.

Some treatments to try at home:

Rest and icing: Rolling a frozen water bottle under your feet can be helpful, but be sure to do this after you stretch not before. You can do more harm than good if you ice, then stretch the area when it is cold. Some people also recommend using a tennis ball and there are specific rollers in running stores. You may also need to take a break from running or find more yielding surfaces to run on for a while until things settle down.

Calf and plantar fascia stretches:

– After each run, I really work on stretching out my calves by stepping back into a lunge with my rear heel down and then bending the back leg to get a little stretch of the lower calf too. You can also stand on a curb or stair and let your heels fall off the edge a bit to stretch. Sitting in hero pose for 30 seconds before and after a run can also help (sitting on floor on knees, resting glutes on heel of feet).

– If I’m having trouble with plantar fascia pain, after runs and periodically throughout the day I’ll stretch my foot itself. To do this, sit and place your affected foot across your knee. Pull your toes toward your shin, stretching your arch and run your thumb along foot (10 seconds).

Plantar fascia stretch

Other stretches include sitting with your legs out straight and loop a towel around your foot. Pull the top part of your foot towards you & hold 10-30 seconds.

– Before I get out of bed in the morning, I circle my ankles to warm things up before I make that first painful step down, which also helps.

Avoid flat shoes or barefoot walking: I definitely need to work on this one, as I have 4-5 pairs of cheap little ballet flats I wear all the time! Some studies show a benefit with over the counter shoe inserts that serve as either heel cups or arch supports, although this isn’t consistent. I’ve been trying some for the last two weeks and they seem to be helping some, but I’ve been more stretching too so it is hard to say what is helping and what isn’t. Prescription inserts are also available.

I also got some supportive flip flops (I know, seems like an oxymoron) to wear around the house and they seem to be helping. They certainly help that first step in the morning now that I keep them by the bed!

Supportive shoes plantar fascia

Braces/Taping: You can apply tape support of to your foot to provide some extra support (see my first trial of KT Tape for my most recent 5K below). There are also a wide variety of braces, wraps and splints marketed specifically for plantar fasciitis. Again, none of these have good controlled trials to show their efficacy but they do seem to help some people.

image

If you’re still having pain after a couple of weeks of trying these things, you should definitely be evaluated by a medical professional. They may recommend a short course of over the counter anti-inflammatories, a prescription insert, a steroid/anesthesic injection, nighttime splinting, or other treatments. Surgery is very rare unless you have other issues.

Prevention

Ideally, we could avoid all running injuries completely, right? That’s not possible but there are some things you can do to decrease your risk.

– Be sure you’re wearing well fitted, supportive shoes. Depending on the shoes and  your running, you may need to replace your shoes after anywhere from 250-500 miles.

– Be careful about increasing your mileage and/or intensity too quickly, particularly if you have any of the other risk factors (middle age, flat feet, overweight).

– Exercises to strengthen your calves and feet may help. Some recommendations I’ve run across include: toe curls with a towel (use only your toes to pull a towel towards you on the floor), toe stretches with a rubberband across your toes, toe squeezes with one of those pedicure inserts between your toes, toe curls around the edge of a step or book and calf raises (on the floor or on a step).

Sources for more information:
Another Mother Runner (www.anothermotherrunner.com) has a great podcast about foot issues I’d highly recommend (Episode 70).
The Body Shop: Arch Enemy on www.runnersworld.com has a 3 minute video demonstrating exercises that can help.
*Sources I used: Primarily UptoDate.com (accessed 8/2013), Runners World
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3 responses to “Plantar Fasciitis, AKA Why I sometimes hobble out of bed in the morning!

  1. […] spot in my right ankle) and know I’ve been really lucky not to have anything other than some plantar fasciitis so far. To be cautious, I’ve decided to start utilizing the cross training option in my Hal […]

  2. […] Speaking of running more and running better, I bought new shoes this week. My plantar fasciitis has been bothering me a bit for the last few weeks, as I’ve eked my mileage back up. That understandably had me a little concerned until I realized that the shoes I’ve been running in are the last pair of new shoes I got before the Princess Half Marathon. When I was training for Princess, I was diligent about keeping track of the mileage on my shoes and noted that I started to have foot pain about mile 250, which resolved with new shoes. These shoes definitely have at least 250 miles run on them now, as I’ve been running in them since January. I’ll also go back to wearing my flip flops more often and stretching, which have all helped me in the past (more about plantar fasciitis and the things that I’ve tried here). […]

  3. […] generally! Also, by not overstriding, I’ve minimized a lot of the trouble I had early on with plantar fasciitis and other aches and pains. There are also lots of tips about using these shorter steps to increase […]

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