What You Need to Know About Plantar Fasciitis

2021 Run Dynamic Max 29

Finding time to be active and properly support your body while doing so has never been more important.

Of the estimated 2 million American patients treated every year, the CDC credits inactivity as the most common risk factor for plantar fasciitis.

Plantar fasciitis is defined as the inflammation or irritation of the thick band of tissue that runs across the bottom of your foot and connects the heel to the toes. Oftentimes, individuals with plantar fasciitis experience stabbing pain at the heel of the foot.

Due to the COVID-19 pandemic, you may find yourself staying indoors and barefoot for work or school, with little room for activity, putting you at an increased risk for developing plantar fasciitis.

Additionally, a sedentary lifestyle means less time wearing shoes, and less support for your feet. In a recent article from the Mayo Clinic Health System, Sara Vande Kieft, P.D.M, noted the impact of life in quarantine on the health of your feet.

“While going without shoes may feel good in the short term, a lack of arch and foot support can increase the risk of foot conditions, including plantar fasciitis.” writes Vande Kieft.

Identifying and treating plantar fasciitis poses a unique challenge to clinicians and footwear outfitters alike. While a sedentary lifestyle can predispose individuals to plantar fasciitis, it is also very common in runners who may be running with improper foot support.

“You go to the dentist and get a check-up twice a year, but we don’t do anything for our bodies. We don’t really do screenings, we just assume our body is in tip-top shape 24/7 and we go run and play sports and do all these different things,” says Dr. Colten Sullivan, PT, DPT, CSCS. “That’s when these injuries present and become inflamed.”

Physical therapists like Dr. Colten Sullivan from Bull City PT in Durham, NC, are attempting to combat the onset of plantar fasciitis through unique programming and preventative screening.

We sat down with Dr. Sullivan to learn more about the prevalence of plantar fasciitis and how runners can best address it.

FF: What is plantar fasciitis and what causes it?

Sullivan: Plantar fasciitis is irritation or inflammation of the plantar fascia that sits basically at the bottom of your foot.

The plantar fascia is important in providing support for the arch of your foot and aids in shock absorption as you walk or run.

FF: What are signs to look for to determine if you have plantar fasciitis?

S: What we look for is basically pain in the heel that is worse when you first get up in the morning or after sitting for a while. This pain can sometimes get better once you get going and get warmed up, but then it's really bad once you stop running and time has passed.

What happens is that the calf muscle (gastrocnemius) tightens up and pulls on the plantar fascia, which causes it to be stretched more than normal when you start walking.

A woman wearing Brooks running apparel stretches her leg before a run

FF: How do you treat it?

S: Treatment for plantar fasciitis starts with stretching the calf and the plantar fascia, followed by strengthening the muscles inside the foot and further up the chain. More specifically, the gluteus medius, gluteus minimus and piriformis muscles. This will help improve the mechanics of the individual to prevent further strain and poor biomechanics.

FF: Can you recommend some at-home strengthening exercises folks can do to avoid PF?

S: A calf stretch is definitely very crucial. One of my favorite ones is putting your foot up on the edge of the curb or stretching your foot on a foam roller. You can use a lacrosse ball to apply pressure to the bottom of your plantar fascia to help get it stretched out.

As far as exercises go, you can do calf raises or heel raises, clam shells or hip abduction. Or there’s an exercise I call the “Colton Shuffle,” which is basically a lateral banded walk. I like to have some fun with that one.

FF: Have you seen an uptick in cases of plantar fasciitis since the pandemic has limited/exaggerated mobility for many?

S: I’ve definitely seen that. Sitting causes our calf muscle and plantar fascia to tighten up, so when you go to get up, that's when it’s stretched and strained.

What are we all doing now at home? We’re sitting on a couch or chair, we don’t have the ergonomic setup we might have had at the office.

Plus, we’re sitting more, and it’s been winter time so we’ve all been stagnant and not doing as much.

Now, people are getting active since the weather is getting nice out, so I see an uptick in plantar fasciitis and general injuries to the lower extremities at this time of year, especially because of COVID-19.

2021 Run Dynamic Max 13

FF: What shoes are best for those with plantar fasciitis?

S: Each runner is different and each runner’s mechanics can change.

I personally leave it up to Fleet Feet to fit the runner with the shoe that fit them best. You guys do a great job of fitting runners based on how their foot lands when they run.

Read more about our Fit Process here.

Dr. Sullivan also recommends being fitted for orthotic inserts, such as Superfeet, to better support your foot while you walk or run. Orthotics can help to normalize the biomechanics of the foot as you move, and alleviate plantar fasciitis pain.

While seeking professional care for any pain or discomfort you may be experiencing, our highly trained Outfitters at Fleet Feet can also help you better understand the way your body moves and how to best support it through your shoes or orthotic inserts.

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FF: Should you wear shoes around the house to avoid plantar fasciitis?

S: Yes, definitely. Wearing shoes around the house so you’re not walking barefoot, plantar fasciitis socks and a night sleeve or a night splint work really well in helping it too.

I will say that people always think they can sleep through the night wearing a night splint right away, and that's not normally the case. Normally they can sleep through half the night before having to take it off because it’s so uncomfortable. So I always preface that so people have an idea of what to expect.

I think that recovery is just as important as the actual exercise itself. People put too much effort into the exercise and less into what their recovery looks like, what their stretching looks like or what their maintenance routine is. That’s normally where people get in trouble and end up noticing a lot of pain.

It’s important to make sure people wear recovery shoes, that they’re stretching and foam rolling and doing the right things. That way when they go to do their activity they’re not getting hurt right away.

While we at Fleet Feet aim to provide our readers with the best information possible, nothing beats the expertise of a medical professional. If you experience new or worsening pain, consult a doctor or physical therapist before taking any further action.

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