Combating Plantar Fasciitis

August 3, 2014 10:19 pm Published by Leave your thoughts

 

by Joe Giandonato, MS, CSCS

 

As a reader of joshstrength.com, it’s doubtful that you partake in distance running; however, you might know someone close who runs regularly. And with the nice weather upon us, it’s likely that you’ll be ramping up your walking outdoors.

 

So what is Plantar Fasciitis?

 

Plantar Fasciitis is characterized by the inflammation of the plantar fascia, which consists of a network of collagen-rich tissue that spans from the toes to the heel providing the medial longitudinal arch support. The plantar fascia covers the entire surface of the bottom of the foot and contains two layers: a superficial layer which is blends from the thick dermis near the front of the foot and a deep layer which is anchored to the heel. The deep layer is heavily involved in toe extension and absorbing shock during heel strike and reducing shearing forces. With repeated activity the fascia becomes taut, triggering soreness on the calcaneus (heel bone) and the entire surface of the plantar fascia. In advanced stages, the pain grows more severe and migrates towards the heel.

 

While overuse and rapidly increasing the intensity and duration of runs are obvious culprits, an underlying issue is foot pronation.

 

Runners and walkers, who rack up a lot of mileage, tend to excessively pronate at the foot. Studies show that nearly 80% of runners pronate and 20% of runners pronate too much. Runners who over-pronate, typically have more a more flexible foot with a collapsed arch, which places strain on the plantar fascia.

 

Also, a lack of dorsiflexion has been pegged as another underlying issue. When dorsiflexion (or toe to knee mobility in the saggital plane) is lacking, the mid-foot compensates by moving, creating more pronation.

 

Additionally, inhibited lateral rotators of the hips, which include the gluteus medius, and weakened quadriceps, gluteus minimus, and the tensor fascia latae contribute to pronation, as they cannot effectively buttress the lower extremity from shear loads and shock from repeated heel strikes.

 

Luckily, plantar fasciitis can be prevented utilizing conservative measures.

 

  1. Rest

 

This is an obvious one. If you are certain that a specific activity is creating the pain cease it and rest. For runners, this might mean taking a few days off to see if the pain subsides.

 

  1. Recover

 

Scour your garage or basement for a tennis ball. Simply roll the tennis ball against the floor, beneath the surface of your foot throughout the day. Roll during your workday, while in class, or while sitting around the house. Once the plantar fascia begins to soften up, search for a lacrosse ball, and glide your foot atop it throughout the day. You might also want to roll a golf ball in a tube sock or stocking, placing it under your foot. This will allow you to target the more intricate areas of the foot’s surface (nearest the toes and the heels) with a smaller, but dense object.

Here’s a video of the tennis ball SMFR:

 

http://www.youtube.com/watch?v=sW-CEzn1cFw&feature=relmfu

 

Alternatively, you could apply a broomstick or theracane to your calves.

 

 

Performing self myofascial release with a tennis ball or foam roller on the calves would also help reduce the tension of the plantar fascia.

 

  1. Mobilize

 

Perform ankle mobility exercises. A few of my favorites include a half kneeling ankle mob against the wall. Assume a lunge position, allowing your rear knee to touch the floor. Place your hands against the wall and bring the knee of your front leg, over your toe and gently tap the wall. Eventually progress to the standing variation as linked to below:

 

 

Another good movement is a three point half kneeling ankle mob. Begin by your knee travel directly straight over the 2nd and 3rd toes, then back and over the big toe, then returning to the starting position, where you’ll finish with your knee traveling over the 4th and 5th toes. Repeat for time or repetitions.

 

  1. Strengthen the lateral rotators of the hip

 

Pronation is often observed in individuals who lack sufficient strength of the muscles which laterally rotate the hip. Strengthening the glute medius would help. Performing low lateral shuffles, X Band walks, side lying clamshells, standing lateral leg raise and lying butterfly glute bridges would help.

 

A typical prevention program would resemble this:

 

Exercise Sets Reps or Duration
SMFR Tennis Ball or Stick Calves Intermittently throughout day :20 to 1:00
Wall Ankle Mobility Drill (Standing or Half Kneeling) Intermittently throughout day :30 or 15 reps
Wall Calf Stretch Intermittently throughout day :20  to :30
Barefoot Calf Raise 1 – 2 sets each day :30 or 15 reps
Hip External Rotation Movement 1 – 2 sets each day and 2 – 3 sets before workout :30 or 15 reps

 

Give it a go, or suggest this article to those close to you who run regularly.

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