Runner's Common Injury No. 1 - Runner's Plantar Fasciitis

February 13th 1:54pm

Why do runners get plantar fasciitis so easily? Plantar fasciitis is especially prone to develop in runners as a result of extensive running or exercise. Plantar fasciitis occurs when the long flat ligament known as the Plantar Fascia on the bottom of the foot stretches irregularly. The strain can also lead to the development of small ruptures or tears and inflammation to the ligament and surrounding areas. All of which is uncomfortable to the runner at best and debilitating at worst.

Surrounding areas can also be put under strain from this and a resultant a chain reaction can form whereby muscles, tendons and other ligaments in the foot and lower leg can also become tight or severely irritated as well. Runners even make allowances for plantar fasciitis either due to the will to continue to run whilst injured or even in the subconscious; which again can lead to all manner of other muscular imbalances elsewhere over a period of time. Quite often the pain and discomfort is such that it is hard to distinguish plantar fasciitis as the root cause or symptom or the site of the original injury.

The pain that results from this irritation can occur at different times for different people but is usually noticeable first thing in the morning or when sudden weight or exerted pressure is put on the inflamed area. An aching lingering pain often follows and generally speaking symptoms do ease when the area is warmed up. However for others the sensations are even more severe with almost acute stabbing pains or nagging pulling that never seems to cease.

Runners are particularly at risk of developing plantar fasciitis. The stress and tension on the sole of the foot and plantar fascia ligament as previously mentioned is a main cause for this condition to develop. It does not necessarily mean that long distance runners are more likely to develop plantar fasciitis but repetitive pounding on the heel of the foot during running of any kind is a huge factor, adding excessive stress to the heel of the foot, therefore contributing to development of plantar fasciitis. Runners who over-pronate (feet roll inwards when they run) are particularly at risk as the biomechanics of the foot for pronation cause additional stretching of the plantar fascia.

Runners should not ignore the signs when feeling this type of pain and it is best to stop running altogether and rest to recover. Additional and unnecessary strain on the heel will aggravate the area even more and can cause the condition and pain to become more severe. Runners can continue to train without putting strain on the inflamed plantar fascia with swimming, pool running or cycling as a substitute to give the fascia a chance to rest whilst keeping up cardio fitness levels. Self treatment should be administered almost straight away in addition to a range of exercises to stretch the plantar fascia and help reduce strain and thereby ultimately reduce inflammation. This combination of rest, self treatment and stretching should hopefully restore good condition; however runners plantar fasciitis can be one of those injuries that lingers on so be prepared to keep right on top of it, otherwise you could be burdened or sidelined for a longer period.

Self treatments for runner's plantar fasciitis aside from rest (or a break from running) include hot and cold therapy, massage, strapping/taping, stretching, extra cushioning and compression.

Hot and Cold packs can provide an easy to administer, clean therapy with the minimum of fuss, preparation or a major clean-up operation afterwards.Hot and Cold therapy can be used independently of each other or together alternating between the two. Short sharp bursts of hot or cold application can work but for this condition longer periods of one or the other can be effective. Essentially given the individual runners specific situation trying different ways often leads to the most effective for them with some trial and error along the way. reusable hot and cold pack is the cleanest most convenient way to self treat although some people like buckets of hot and cold water to plunge the foot into!

General and varying depths of massage strokes along (primarily) the bottom of the foot helps along with more detailed area, deeper concentrated efforts with the thumbs into the arch, around the heel and sideways across the foot; also relieves tension and stretches out tissue within the foot. Holding the metatarsals and spreading them apart can also provide relief. Using a massage tool saves the hands and sometimes allows deeper self treatment although some caution should be exercised to ensure that you are not causing more damage of course.

Holding the toes back and stretching the foot with the calf muscles also helps. This stretch can be long and drawn out working to the barrier of resistance before trying to develop the stretch further; alternating this with arching the foot back the other way gently at first or sideways (both ways) in a similar fashion to the metatarsal movement previously. A resistance band could be helpful for this exercise as well.

Plantar Fasciitis night splint is a popular and effective way in the war of keeping on top of the condition for many, whereby an overnight long deep stretch can be administered for persistent or advanced plantar fasciitis in runners (or indeed generally speaking).

Strapping and taping - the foot to support the arch during the day also provides relief for many and there are plantar fasciitis straps available, instead of using zinc oxide tape, especially if you are not used to using tape yourself.

Compression socks - offer light support to the overall area and encourage enhanced blood flow and warmth throughout the lower limb. Compression socks are becoming very popular with runners and can be also be worn following recovery, during running or for recovery purposes. Support socks can also help.

Even as an experienced runner the choice of running footwear and indeed lifespan of a running shoe can be misread and it is always worthwhile making sure that your running shoes still possess the cushioning and support properties and that these are still what you require. Cushioning will diminish with mileage run, even on the most technical and expensive running shoe, so a record of this in a runners training log always helps. In addition how the runner as an individual strikes the ground effects the composition of the shoe in different ways and it is always worth checking this with fellow running club members or your local or online running specialist. Change your running footwear at the appropriate time. Whilst for many it is the case of sticking to one particular running shoe brand or model it is worth exploring the options or asking advice. Make sure that if nothing else your footwear is good quality and is right for your foot strike type and the type of running you do. Similarly check your everyday shoes and consider either a plantar fasciitis strap or strapping and taping as mentioned previously or indeed a cushioned or supportive insole perhaps.

Some important tips for runners that may reduce the chances of developing plantar fasciitis:

Learn your best preparation for running - Stretching the plantar fascia ligament is one way to warm up before putting any sudden stress on the heel of the foot during running. Debate is often furious on when to stretch and how to stretch for running but in truth the level of stretch is important and very personal to the individual. Some need ballistic movements ahead of going out for a run or event whilst others need very light movements to awaken joints, tendons and muscles in preparation for activity.

Change your routine gradually - Set a programme increase gradually and ease into it. Distance and difficultly are prime factors here. Having an idea of where you want to be and a timeframe of when you want to be there should allow you to be able to set realistic goals, that if followed will allow you to progress without setback. Seek the advice of a coach or look up a programme, set and follow a plan.

Rest regularly for long routines. If you have had Runner's Plantar Fasciitis, when you start running long distances again it is worth considering intermittent rest in order to relieve the constant stress on the plantar fascia.

Wear the right running shoes - It is important that runners know what type of running footwear they require and that they then chose a high quality running shoe. This should not only be the right type required (i.e. Neutral or Motion Control/Stability) but should also provide the best possible fit in line with their particular foot shape. The different brands of running shoe offer many variables to the fit and feel and it could be that one is better to suited to you specifically. The right balance of support and cushioning to the heel and arch of the foot is a main goal in individual choice of running shoe.

Cold therapy - You will have a kit bag of running essentials at home or for events and this should include a few items for medical needs such as blister plasters, sun-cream, antiseptic gel, Vaseline, Savlon or wet wipes perhaps. However a reusable hot and cold pack is an inexpensive and clean way of delivering immediate and ongoing self therapy and a couple on the go is a wise investment.

Self massage - This remains the easiest and most effective remedies known and whilst many enter into this as the unknown generally speaking for any ache or pain getting hands on and rubbing the area at varying degrees of pressure and concentration will help. As a few general rules; if inflamed leave the immediate site of inflammation alone; Do however massage/stroke the area above the injured area (i.e. towards the heart) towards the centre of the body to encourage removal build up of waste material; Always follow the body towards the centre point (towards the heart); use a lotion/oil to avoid friction injury and allow smoother passage of massage; use different types of massage stroke including smooth long deep strokes, concentrated deeper efforts across muscles; kneading. Use a massage tool to save your hands, fingers or thumbs. If the administration of self massage is very painful stop immediately.

Professional help - There are problems with self treatment. We tend to give up treating ourselves very easily. The angle at which you can treat yourself tends to be awkward. You feel the effects as well as the feedback from your hands which can confuse. If you are not a therapist more often than not you do not know for certain that what you are doing is at the right spot or at all beneficial. It is always best practice to seek professional help. Often not seeking advice or treatment can ultimately prove to be a false economy anyway. Be rest assured and go and see a reputable therapist. Getting to know yourself inside out may take some time but through some research, ultimately keeping in control of what you chose to do, when you have treatment and how often, plus following advice after or in between therapy visits will help you recover quicker and help you avoid repeat injury.

Top Tips for Running Injuries:

 

  • Don't ignore the signs
  • Rest to Recover
  • Seek advice from those around you
  • Read up on the condition
  • Self Treat
  • Seek Professional advice
  • Follow professional advice
  • Give treatment a chance to work
  • Don't Panic
  • Check your footwear
  • Examine your running
  • Check out your running schedule
  • Time to start planning your running?
  • Keep positive
  • Learn from the experience
  • Cross Train
  • Keep in contact with running
  • Use your time out wisely

General summary statement

Do you run with pain? If so you need to ask yourself why. Whilst generally speaking we run to our own levels and the action of running puts strain on our bodies and joints, it should never be to the point of actually being painful. Don't ignore pain or signs of injury. There are often even little changes you can make to stop these feelings and certainly as a way of ensuring that a warning sign of pain or discomfort does not then develop into something more serious. Running can and should be safe. Ask questions of fellow runners. Join a club and learn how to run or train. Ask more questions. Look up advice on the subject. If you cannot pinpoint or label an injury or concern, read running websites for more general information which should home you in on the right area. Visit your local running specialist. Seek advice from a Professional (Runners - Get to know yourself inside out). Just do something and never ignore the signs!

Newsletter Sign-up

Don’t miss out on special offers, news, sports injury advice & discounts!

Sign up to our newsletter