Tips on how to resolve Plantar Fasciitis

Plantar Fasciitis, a painful condition affecting the soft tissues of the heel and sole of the foot, has come up in the clinic a few times over the past week with our Marathon runners. The following is a typical scenario for you and some basic advice… I hope it helps those of you that are struggling with this problem.

‘I have suffered with plantar fasciitis for the past 4 months. I’ve spent the last 6 weeks resting and I am awaiting custom made orthotics. I have been trying to stretch the foot as much as I can during the day, and ice it every now and again. However, the pain has not settled; as soon as I run at all it is still there. Up until this point I have ‘managed’ the condition by running every other day and by limiting my mileage. Should I give it all up to become a couch potato? I can’t see any other form of exercise fitting my lifestyle so well. I have been a runner all my adult life and it fits in around family commitments’.

Don’t hang up your running shoes just yet! It sounds as if this is a long-standing problem that unfortunately you may have made worse by continuing to run in the early stages (albeit with reduced millage) and with foot stretches. Rest and custom orthotics are a great start but the good news is there’s more you can do to help. Current thinking regarding stretching is that it’s often counter-productive in the painful stages. If you know that you have a ‘pronatory foot posture’ or a ‘flat foot’ then your tissues are likely to be irritable in the first place due to overstretch and stretching could irritate them further. Start by treating the problem locally. Massage the fascia by rolling the sole of the foot on a rolling pin or a frozen water bottle (run it under the hot tap for a few seconds first to remove any frost and protect from ice burns) for 10 minutes every day. Ask your podiatrist or a sports Physiotherapist to show you how you can tape the foot during the day to off-load the stress on the tissues and allow them to rest properly. Investing in some treatment involving soft-tissue massage for the Fascia and calves, assessment of your running style and correction of postural alignment and muscle control (including balance and strengthening work) will also pay off in the long-term. Once the pain is settling, then it’s time to stretch both calf muscles (Soleus and Gastroc). Do this gently, but as often as possible; ideally 5-6 times a day. Consider investing in a Plantar Fasciitis splint such as a Strasburg sock which allows you to stretch during the night. If however you have the less common scenario of a high arch rather than a pronated or flat foot, then these splints are advocated earlier in the regime, as is stretching. Finally, if you’ve not gone down the route of getting orthotics then at least make sure that your trainers are the correct ones for your foot posture.

If you’ve covered all of these options you should be in good shape. However, if you are still struggling, then there are other non-surgical options such as shock-wave therapy or injections that can be considered, and which you will need to explore with a foot and ankle consultant or sports med Physician.

A note for those of you training for the London Marathon; once you do get back to training, do not try to play catch-up with your training schedule! Ease in gently and with advice from your coach and or physio.