Plantar Fasciitis
The plantar fascia is a fibrous band that runs lengthwise along the bottom of the foot from the heel to the ball of the foot. The plantar fascia supports the longitudinal arch and is essential for toe-off, the part of a person’s stride where the toe pushes off the ground. Inflammation of this structure is called plantar (bottom of the foot) fasciitis.
Symptoms
- Pain
- Swelling
- Limited range of motion
- Reduction in movement
- Stiffness
Causes
- Highly arched feet
- Flat feet (over-pronator)
- Shoes (excessive wear)
- Training errors (increase mileage/intensity too fast)
Treatment
- Eliminate the cause: i.e. running, lifting weights, wearing heels, etc.
- Rest: Decrease running by 25-50%, depending on the severity of symptoms; substitute with non-weight bearing cross training (cycling, swimming, pool running).
- Ice the site: Freeze a can of water (soda cans are too weak) and roll the frozen can under the foot from the heel to the ball for 10-15 minutes two to four times per day.
- Anti-inflammatory medications: If you are able to tolerate them, anti-inflammatory medications (such as ibuprofen, naproxen) can help relieve inflammation and pain.
- Take these medications with food and as directed on the bottle; check with your physician if you are taking other medications or have any medical conditions.
- Devices: arch supports, heel cups, orthotics (custom-made arch support) may be helpful in decreasing pain and stress on the plantar fascia.
- Stretching: Strengthening and stretching exercises for the calf and foot muscles.
- Calf stretches: typical Achilles stretches, hold 20-30 seconds.
- Repeat 5-10 times per day. Plantar fascia stretches: pull your toes up to stretch the bottom of your foot.
- Hold 20-30 seconds. Repeat 5-10 times per day.
- Towel curls: with your heel on the floor and your toes on the edge of a small towel, curl your toes to pull the towel under your foot. Repeat 5 times.
- Leg strength: put a weight around your foot. Point your foot up (10 reps), down, in and out. Repeat each set of 10 repetitions three times.
- Foot massage: roll your foot over a golf ball, rolling pin or similar device to help stretch the fascia, especially following activities. You can also use your thumbs to massage and stretch the fascia.
- Shoe maintenance: replace broken-down running and exercise shoes before they cause problems. Make sure that the shoes you wear on a regular basis are in good shape and provide adequate cushioning and arch support. In rare instances, a cortisone injection may be needed to decrease symptoms.