One of the most common injury conditions for Lifetime Athletes…is the demon known as Plantar Fasciitis! It frustrates and debilitates many athletes, but it is a problem that can be solved. We just need to understand what it is, how it develops, and how to make it go bye bye forever.
Plantar fasciitis, and improving foot function, is the focus of this week at The Lifetime Athlete. May is Human Locomotion Month and this is sure to be a popular topic. The MasterClass will cover it in detail on Wednesday (registration open til noon on Tuesday), and we’ll also give this subject some air time on the podcast and YouTube Channels (later this week). But for now…let’s go over some key considerations regarding Plantar Fasciitis. I’m going to approach this brief post in a Q&A format.
“What is the plantar fascia?” Also known as the plantar aponeurosis, which is basically anatospeak for a flat sheet of tendinous material in the bottom of the foot, the fascia runs from our heel to the base of the toes. It’s mostly made of strong, straight fibers of Type 1 collagen.
“How does the plantar fascia work?” Essentially, it functions as a windlass mechanism during the stance phase of gait (refer back to last week’s article, podcast, or video for more details). As our heel begins to lift off the ground and the toes (especially #1) bend (extend), the tension in the fascia helps to pull up the arches of the foot and lock the foot into a rigid structure for effective push off.
“What causes plantar fasciitis?” The condition is mainly brought about by load mismanagement. More specifically, if we fail to resupinate our foot in the terminal phases of stance, our foot remains flexible and the plantar fascia has to try to do much of the work that was intended for the skeletal system. Bones carry loads well, but soft tissues like the fascia, and it’s attachment to the heel at the medial calcaneal tubercle, get angry and inflamed if they are chronically experiencing microtearing from inefficient mechanics.
“What are the symptoms?” Heel pain at the fascia attachment is most common, with soreness often migrating around the medial heel and out into the arch. There is often a “U-shaped” curve of pain during the day, with first thing in the morning being problematic as well as at the end of a long day.
“How do I manage the acute or early symptoms?” Basically, you’ve got to get loads down to let the tissues calm down and the inflammation subside. This probably will involve cutting back on training and on-your-feet time, to varying degrees. The body can repair itself if you take the aggravating factors down below the level which represents the threshold for inflammation. Gentle exercises in non-or-partial weight-bearing, supportive shoes and orthotics, night splints, and various anti-inflammatory modalities or meds might have a place here, but they are all designed to support healing and be temporary when applied correctly.
“What do the later stages of rehabilitation look like?” This is where you progress into gradually increasing loads as your body adapts, with some plateaus and regressions, until you reach your prior or desired level of function and training. That’s the easy answer. The more detailed explanation is that you need to restore optimal movement patterns in the foot, lower extremities, and whole body. Mobility, stability, strength, and power are all part of the equation and using static and dynamic stretches, isometrics, eccentrics, concentrics, and plyometrics are all indicated. In most cases, if this is done well, proper foot function will be restored and the athlete will be pain free without needing special orthotics, shoes, or voodoo.
“How do I most effectively return to my desired levels of training?” By being patient is probably the first thing to say. You want to stay at a low level of training while you are fixing any restrictions or weaknesses you have (and if you had plantar fasciitis, you probably had some deficits that need attention). Ultimately, we want to achieve good foot mechanics, high durability and resilience, and use intelligent programming.
“How do I keep this problem from ever coming back?” Consistency may be the most valuable descriptor here. By being relatively consistent with healthy foot movement/function such as some barefoot training, maintaining good quality in all your movement patterns, and keeping your training between your minimum effective dosage and maximum absorbable dosage…you should be good to go.
So those are some brief points to consider if you need to deal with plantar fasciitis. Obviously, we’ll be diving more deeply in the MasterClass, so if you want to get pain-free and functional, and learn how to eradicate heel pain, join us. Beyond that…get yourself a good PT. You can get help treating this condition very efficiently using a telehealth, or online model when you work with an expert. And of course, make your training plans and programs more effective by working with a good coach who knows your needs and cares about your success.