Plantar fasciitis its not just about the feet

Plantar fasciitis is a common running injury which causes a frustrating pain that comes in sharp
bursts, often making running torture. Typically, the pain is bad in the morning, then
eases with warming up, then it comes back to bite you at rest or days end, sometimes with
stiffness in ankle or big toe, too.
Your plantar fascia is a thick fibrous band of connective tissue that starts under the heel and
runs along the sole of the foot towards the toes. It keeps the foot bones and joints in position
and enables us to push off from the ground, plus it helps limit how much we can flattening the
arch of our foot. Plantar fasciitis occurs when your plantar fascia develops micro-tears or
becomes inflamed. This tends to be made worse by bruising (e.g. heel-striking) or
overstretching the plantar fascia, usually in running activities.

Who tends to get plantar fasciitis?

According to the Mayo Clinic, plantar fasciitis is most common between the ages of 40 and 60,
when the muscles supporting the arch of the foot often become weaker.
Other groups with a tendency to get plantar fasciitis include:
heel strikers
people with very high or very low arches
overweight people
those with tight and inflexible calves and Achilles tendons
runners/walkers who are walking or running barefoot on soft sand for longer than they
are ready for
runners who have moved too quickly to low profile/barefoot-style shoes before their
muscles and ligaments are ready for them

What causes it?

Podiatry Today (I usually just read it for the pictures) reports that its been long believed that
reduced ankle dorsiflexion (how much you can lift the top of your foot towards your shin) is the
most important risk factor for the development of plantar fasciitis.1 When this combines with a
tight Achilles tendon, theres a tendency to compensate by pronating the foot more (foot rolls
inwards and the arch of the foot flattens), which stresses the plantar fasciitis.2
Californian research concluded that tightness or weakness in the soleus can also contribute,
since the soleus is used to stop the foot collapsing on impact. The soleus is the muscle you see
in the lower calf, although it runs all the way from the back of the knee and the heel.
Wearing shoes with poor arch support or stiff soles can be a factor. It's also important to replace
old runners before they stop supporting your feet thats at around 650-800km, but the less
drop between heel and toe, the quicker they wear out.

Preventing plantar fasciitis what you can do

Use your toes
A team from Canada studying the role of the big toe in running noted a lack of plantar flexion
(pushing toes down) resulted in a lack of energy generation during the press-off from the
ground. This meant more energy was absorbed and dissipated through the foot, causing more
stress on the plantar fascia. They concluded that forcing the big toe downwards primed the
lower leg muscles for greater force return and helped protect the foot.
You can work on this by:
toe-clawing on carpet
sprint drills (even if youre an endurance runner)
Running on soft sand, where the technique is to clench your toes at the point of impact
picking up a pencil on the floor with your toes while sitting
exaggerating the toe push while walking.

Strengthen your soleus

Do some type of calf / toes press exercise for high reps (20+) with a bend at the knee

Avoid heavy heel striking

If you do heel strike, make sure you have a well-cushioned shoe and avoid striking out in front
of your hips.
Get the right shoe for you
If youve had plantar fascia pain, get proper advice on a shoe has the right heel-to-toe drop for
you and the right build for your level of pronation

Wear compression socks

2XU compression socks can help raise proprioception in the foot muscles (raising your
awareness of using the muscles) and provide support to the arch of the foot, the Achilles tendon
and the calf. 2XUs VECTR socks even have X-LOCK technology a strong nylon panel
through the arch and over the base of the Achilles tendon specifically to help protect the plantar
fascia by providing support to the foot.

Stretch right
If you have plantar fascia pain, put in two sessions a day doing each of these stretches three
times, holding the stretch for 40-60 seconds.
Gastrocnemius stretch stand with both feet flat on floor, one directly in front of the other.
Keeping the knee of the back leg straight, lean forward but keep most of your weight on your
back foot until you feel the stretch in the calf and Achilles tendon of the back leg.
Soleus stretch do the same as above, but this time bend the back knee this relaxes the
gastrocnemius muscle (bulky muscle seen high in the calf) so you can focus the stretch on the
soleus. Lower your body, keeping back upright and most of your weight on your back foot.
Flexor hallicus longus (FHL) stretch stand close to a wall or step with one feet in front of the
other. Rest the toes of your front foot against a wall/step while your heel remains on the ground.
Bend the front knee a little and push it gently push towards the wall.

Dom Cadden coaches the Nutcrackers strength training for runners group and individual
training at Iron Grip Gym in North Sydney. WTFitness@tpg.com.au

1. Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: A matched case-control study. J
Bone Joint Surg Am. 2003; 85(5):872-877.
2. Riddle DL, Schappert SM. Volume of ambulatory care visits and patterns of care for patients diagnosed with
plantar fasciitis: A national study of medical doctors. Foot Ankle Int. 2004; 25(5):303-310.