Running is becoming one of the most common sports activities all over the world. However, with its increasing popularity comes the increasing prevalence of running-related injuries. Plantar fasciitis is an overuse injury characterized by localized heel or arch pain which increases with your first steps in the morning or after prolonged inactivity. Additional symptoms include foot/ankle stiffness, swelling over the heel and tenderness at the insertion of the plantar fascia. For runners, pain tends to lessen after the warm-up phase but reappears towards the end of a run. Both men and women are affected, however it is slightly more prevalent in women. The incidence of plantar fasciitis ranges from 4.5 to 10% in runners, making it the third most common running-related injury after shin splints and Achilles tendinopathy.
The plantar fascia is a dense connective tissue that extends from the heel bone (calcaneus) to the heads of each mid-foot bone (metatarsals). It functions to support the medial longitudinal arch at the bottom of your foot. While running, the vertical ground reaction force applied to the foot can be double or triple an athlete’s body weight. This places a great deal of stress on the arch of your foot and puts runners at a higher risk for injury to the plantar fascia. There are both intrinsic and extrinsic risk factors for developing plantar fasciitis. Intrinsic factors include both high or low foot arches, obesity, leg length discrepancy, foot over-pronation, calf muscle and Achilles tendon tightness, foot weakness and atrophy of the fat pad in our heel. Extrinsic risk factors include poor footwear and improper training such as a sudden increase in the distance, intensity and/or frequency of running.
Physiotherapy management strategies for plantar fasciitis include soft tissue massage and other manual treatments, stretching and strengthening exercises, orthotic devices, athletic taping and other modalities including ultrasound and ice. Although full recovery from plantar fasciitis can take up to two years in some cases, research has shown that 85-90% of people are successful with conservative treatment. If you are experiencing plantar fascia pain, it is important to get an assessment by your healthcare provider in order to determine the best management plan for you.
Written by: Vanessa Younes, MScPT