If you participate regularly in endurance sports, there’s a relative inevitability that some sort of injury or ailment will present itself. On of the more common and troublesome injuries for many athletes is plantar fasciitis.
What is plantar fasciitis?
Plantar fasciitis (PLAN-tur fas-e-I-tis) is the most common cause of heel pain, affecting approximately 2 million people each year. It occurs when a thick band of tissue (plantar fascia) becomes irritated and inflamed. Patients with plantar fasciitis report a stabbing pain in their heel.
What are the primary causes?
The plantar fascia is a band of tissues that run across the bottom of the foot and connect the heel bone to the base of the toes. It supports the arch of the foot and absorbs shock when walking/running.
Tension and stress on the fascia can cause small tears to occur. The repeated stretching and tearing causes irritation and inflammation, although the cause remains unclear in many cases of plantar fasciitis.
This inflammation may be aggravated by shoes that lack appropriate arch support and by the chronic irritation that sometimes accompanies an athletic lifestyle.
Risk Factors
Many factors can make an individual more prone to the condition including:
- Tight calf muscles
- Obesity
- High arch
- Repetitive impact activity (e.g., running)
- New or increased activity
Dr. Danny Gomez DPM, FACFAS, urges anyone experiencing persistent foot pain to see a doctor. Start with your primary care doctor or a podiatrist (a physician and surgeon who treats the foot, ankle, and related structures of the leg).
“Do not ignore pain or put continued pressure on the foot. Prolonged stress can cause more permanent damage and result in chronic heel pain that hinders your regular activities,” he advises.
I have plantar fasciitis, now what?
Following an exam, or in some cases imaging (i.e., x-rays, MRIs), your doctor may suggest simple, non surgical treatments for plantar fasciitis. The good news: more than 90% of patients will improve within ten months of starting these treatment methods.
- Rest and decrease or stop the activity that is exacerbating the condition
- Ice for 20 minutes/day
- Non steroidal anti-inflammatory medicine (i.e., ibuprofen or naproxen)
- Stretching your calves and plantar fascia
- Cortisone injections
- Orthotics (shoes with thick soles and extra cushion)
- Night splints (these stretch the plantar fascia while you sleep)
- Physical therapy focused on stretching the calf muscles and plantar fascia
Note, surgery is only considered after the failure of 12 months of aggressive non surgical treatment.
Exercises for triathletes with plantar fasciitis
We asked physical therapist David Chen, DPT, OCS for his go to exercises and stretches for athletes with plantar fasciitis. He explained that exercises and stretches should be pain-free. If these are painful, seek a medical professional for an evaluation.
Standing Gastroc Stretch
- Begin in a standing upright position facing a wall
- Place hands on the wall and extend one leg straight backward, bending the front leg until a stretch is felt in the calf of the back leg
- Hold for 30 seconds and repeat 3 times on both legs
Standing Soleus Stretch
- Begin in a standing upright position facing a wall
- Place hands on the wall and extend one leg backward with knee bent, lean forward into the wall until a stretch is felt in the lower calf
- Hold for 30 seconds and repeat 3 times on both legs
Seated Plantar Fascia Stretch
- Begin sitting in a chair with one leg crossed over the other knee
- Use one hand to hold your ankle and the other to hold your toes
- Pull the toes backward until a stretch is felt in the bottom of the foot
- Hold for 20 seconds and repeat 3 times on both feet
Eccentric Calf Strengthening on Step
- Begin standing with heels resting off the edge of a step and a small hand towel rolled up placed under your toes
- Hold onto a stable surface for support as needed
- Raise both heels up as far as you can, focusing weight on the balls of your feet, then lift one foot off the step
- Slowly lower the heel of your standing leg back down to the starting position
- Repeat 10-12 reps and complete 3 sets on both feet.
- Make sure to lower heel down slowly over a count of 3 seconds
Danny Gomez, DPM, FACFAS, earned his board certification from the American College of Foot and Ankle Surgery. He earned his undergraduate degree from Fordham University and received his doctorate from the New York College of Podiatric Medicine.
David Chen, PT, DPT, OCS, is a board certified Orthopedic Clinical Specialist from New York Institute of Technology. He earned his doctorate from Rutgers University and his undergraduate degree from University of Michigan.