Plantar Fasciitis is one of the most common movement based disorders in running athletes at all skill levels and in people of all ages, but why?
As someone begins running and increasing their distance (and as a result increasing stress into the tissue on the bottom of the foot or plantar fascia), the plantar fascia fails to adapt to the load applied. This is like someone who tries to bench press heavier than they could handle before their muscles had a chance to grow adequately and are not ready for that amount of weight. The plantar fascia does not adapt/strengthen quickly enough as you ramp up your running distance or speed.
It’s not uncommon to hear coaches or trainers tell their athletes or patients to “work up to that weight” or “work up to that distance” in terms of training. Let’s use running an example:
Your goal is to run a marathon. You know better than to start out going from couch to 26.2 miles. It’s a better idea to start low and slow, with a one-mile run or a 30 seconds on/30 seconds off run/walk. Over the course of the training plan you would gradually increase the load (distance or speed) applied.
This allows for the tissue, in this case the plantar fascia, to adapt to the load applied over time. If it is stressed beyond its capacity the tissue can fail over time, leading your brain to tell you it hurts as something is wrong.
There are several treatment options available for short-term pain relief. These include icing, myofascial release, instrumented assisted soft tissue mobilization, stretching, manual manipulation, taping, and in cases that don’t respond surgical procedures may be an option.
Long-term (6-8 weeks for tissue adaptation) treatment will typically include loading exercises and strategies to stress the plantar fascia just enough, and progress the load applied to return to training. Taking time off from training or bracing/immobilizing are typically not recommended as this does not keep the tissue stressed to further adaptation for a higher load!
Oftentimes, pain at the bottom of your foot is not due to plantar fasciitis. It can be related to joint movement, poor motor patterns (the way your brain uses the muscles), poor foot mechanics, or even an issue elsewhere in the body (spine, ankle, calf, knee, hip, etc.) leading to the perceived pain in the plantar fascia. It could even be as simple as wearing a shoe that is not a good design for your foot.
If you or someone you know is experiencing foot pain, our #1 recommendation is to be evaluated by a chiropractor or physical therapist knowledgeable in diagnosis and treatment of movement disorders.
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