On Plantar Fasciitis….

When I don’t know about a subject other than suffering the injury, I turn to a professional for some clarity – here is my PT friend Jessica Garcia on plantar fasciitis:

“As runners, more than likely every one of us has had a pain in our heel or foot at one time or another and our first thoughts have been, what is it and can I still run , and probably not in that order. Typically we will try to ignore it hoping that it goes away and if it doesn’t we will look to our fellow runners or the internet for answers. Somewhere in this process we are bound to come across the term plantar fasciitis and wonder if that’s what the problem is and if so how do we fix it. So let’s take the mystery out of this thing they call plantar fasciitis.

The plantar fascia is the thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes. It is made of collagen, a rigid protein that’s not very stretchy. Plantar fasciitis is the inflammation or tiny tearing of the plantar fascia.

Tell-tale signs of plantar fasciitis include sharp pain in the heel when getting out of bed in the morning due to being in a contracted position overnight. Other symptoms include a dull ache along the arch or bottom of the foot which can be sharp, as well as a tight and painful sensation at the base of the heel.  The pain gets worse when you climb stairs, stand on your toes, stand/sit for long periods of time and at the beginning of exercise. The pain gets better or goes away as the foot limbers up but returns when exercise is completed.

The causes of plantar fasciitis can be broken down into two categories: intrinsic factors, those related to the body itself, and extrinsic factors, those “outside” the body. Intrinsic factors are decreased core strength (stable core reduces stress on spine and stops pain transference to foot), decreased flexibility of calf, hamstrings and hip flexors, and biomechanical issues including flat, high-arched feet  and increased foot pronation. Extrinsic factors can primarily be thought of as training errors: improper/worn shoes, sudden increases in training mileage or elevation; beginning speedwork; running on hard surfaces or simply overtraining.

The tricky thing about plantar fasciitis is that many people can continue to run with symptoms—the condition has to be pretty severe to make a stubborn runner with a high pain threshold stop training. Having said this, there are times when it’s better not to push through the pain. Using a red (stop), yellow (caution), green (go) spectrum the following can be used to help answer the burning question of to run or not to run:  Red: Ongoing, arch pain & tenderness that doesn’t fade even once you’ve warmed up, Yellow: Pain when you step out of bed, get up after prolonged sitting or during the first few minutes of a run, Green: Pain free all day including first steps in morning, walking barefoot on hard surfaces without an issue. Plantar fasciitis can be a nagging problem, which gets worse and more difficult to treat the longer it’s present. If pain persists it’s a good idea to see a professional. Conservative treatment significantly decreases symptoms in about 95 percent of sufferers within six weeks however fixing the problem relies on determining the responsible process.

The bottom line is that plantar fasciitis is an overuse injury. Overuse injuries are the great equalizer, taking out the elite and weekend warrior alike. Most runners experience their share of injury, and although many of these conditions can be nagging, few are more so than plantar fasciitis.”

  • Jessica Garcia is a PT in Paramus, NJ and has her own practice – Ultimate Motion


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