Plantar Fasciitis: What it is and what to do if you get it?

After a strong week of running consistently, long distance and at a good pace, I woke up Sunday morning with severe and uncomfortable pain in the arch of my right foot. My Saturday morning run went fine and nothing seemed to bother the foot the remainder of the day…so I was confused with the sudden pain on the bottom of my foot. Out of fear and because it’s often what us runners do…I ignored it for the remainder of the day…limping while walking, skipping my planned long run and hoping the pain would just go away. Well surprisingly enough – it did. By afternoon, the foot felt fine. I put my foot in an ice bucket filled with water and ice cubes that night and hoped it would all be a distance memory in the morning. Monday morning came and the pain was back. I iced it again and waited until mid-day when it had completely gone away. I attended my team’s evening practice and with all feeling good, went for the five-mile run with no problems. I asked my coach his perspective and upon the suggestion of a San Francisco-based running friend, started to do some research on Plantar Fasciitis.

After a quick read-up on the ailment and its symptoms…it was clear. I am suffering from Plantar Fasciitis.

Plantar fasciitis is inflammation of the thick tissue on the bottom of the foot. This tissue is called the plantar fascia. It connects the heel bone to the toes and creates the arch of the foot. Plantar fasciitis occurs when the thick band of tissue on the bottom of the foot is overstretched or overused. This can be painful and make walking more difficult.

According to experts, you are more likely to get plantar fasciitis if you have:

  • Foot arch problems (both flat feet and high arches). (For those that know me…I have a very high arch. Until now, I never knew there were potential complications that could result from having a high arch. More on that here.)
  • Long-distance running, especially running downhill or on uneven surfaces
  • Sudden weight gain or obesity
  • Tight Achilles tendon (the tendon connecting the calf muscles to the heel)
  • Shoes with poor arch support or soft soles

Plantar fasciitis is seen in both men and women. However, it most often affects active men ages 40 – 70. It is one of the most common orthopedic complaints relating to the foot. Plantar fasciitis is commonly thought of as being caused by a heel spur, but research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis.

My high arch that I've always been proud of but am now wondering if it is behind some of my recent foot pain.

The most common complaint is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn. The pain is usually worse:

  • In the morning when you take your first steps. (In my case – I felt the pain in the morning after a long sleep as well as after sitting for a while.)
  • After standing or sitting for a while
  • When climbing stairs
  • After intense activity

Signs and symptoms:

  • Tenderness on the bottom of your foot
  • Flat feet or high arches
  • Mild foot swelling or redness
  • Stiffness or tightness of the arch in the bottom of your foot.

Treatment: I am in the process of icing and stretching my foot as often as possible. Additionally, I plan on purchasing a new pair of shoes with better arch support – something I’ve been too casual about. According to my research, you health care provider will usually first recommend:

  • Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce pain and inflammation
  • Heel and foot stretching exercises
  • Night splints to wear while sleeping to stretch the foot
  • Resting as much as possible for at least a week
  • Wearing shoes with good support and cushions

Other steps to relieve pain include:

  • Apply ice to the painful area. Do this at least twice a day for 10 – 15 minutes, more often in the first couple of days.
  • Try wearing a heel cup, felt pads in the heel area, or shoe inserts.
  • Use night splints to stretch the injured fascia and allow it to heal.
  • If these treatments do not work, your health care provider may recommend:
  • Wearing a boot cast, which looks like a ski boot, for 3-6 weeks. It can be removed for bathing.
  • Custom-made shoe inserts (orthotics)
  • Steroid shots or injections into the heel
  • Sometimes, foot surgery is needed.

Expectations (prognosis): Nonsurgical treatments almost always improve the pain. Treatment can last from several months to 2 years before symptoms get better. Most patients feel better in 9 months. Some people need surgery to relieve the pain.

Complications: Pain may continue despite treatment. Some people may need surgery. Surgery has its own risks. Talk to your doctor about the risks of surgery.

Prevention: Making sure your ankle, Achilles tendon, and calf muscles are flexible can help prevent plantar fasciitis.

Side note: As of late, I have been wearing out the toe area of my running shoes very quickly. It seems my big toe has been moving up and down more often and creating a hole in the top mesh are of my shoes. If you look at your foot when you raise your toe, you will notice that your arch and plantar fascia stretches or flexes. I am now wondering if this is all related…

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