Hasewaga et al (2020) assert that 1 in 10 people will develop plantar fasciitis in their review of minimally invasive treatment of plantar fasciitis. The term itself is applied to inflammation and micro-tearing of the plantar fascia. Your plantar fascia is a thick band of tissue running along the arch of your foot, from your toes to your heel. The plantar fascia becomes a source of pain in trainees who over-pronate or wear flexible, minimalist shoes without the appropriate amount of strength in their foot muscles. The symptoms are pain and tenderness along the arch and heel.
Different from plantar fasciitis, athletes can also strain the plantar fascia. This strain usually occurs in the early stages of training and is associated with running, jumping, and other repetitive stresses. Athletes who are overweight, have tightness in the muscles of the calf, and weakness in the supporting muscles in the foot are at highest risk. If untreated, a strain will develop into a nasty case of plantar fasciitis, taking upwards of eight months to resolve. Age, 40-60 year olds, weight (people with high BMI), poor body mechanics, such as poor ankle flexion, all show a higher prevalence of plantar fasciitis[2].
Stand Firm on Foot Training
So, it’s important to consider training the intrinsic musculature of the foot and the lower extremity but also improving the metatarsal phalangeal joint (MPJ) range of motion. The MPJ is the largest is the largest joint of the foot and has the greatest range of motion in the sagittal plane, and though it is smaller than the ankle, knee, or hip, it is the connection to the ground for the body and is subject to great forces during running and jumping movements[3]. Essentially, whether you are jumping, running, or doing a big Olympic lift, you are pushing off the ground on your toes and flexing your foot. Weightlifting coach Robert Takano likes to say, ” Athleticism starts from the bottom of your feet, the way you move them eventually determine how good of an athlete you can be”. Well, he couldn’t be any more right about that in relation to the plantar fascia.
So, it’s safe to assume that exercises that create a powerful triple extension of ankle, knees, and hips – such as the weight lifting exercises like the snatch, the clean and the jerk – are effective in training the intrinsic musculature of the foot as long as the heel is raised maximally pushing off the ground, and that the fascia is also being stretched to beneficial effect. The problem arises when there are weaknesses in the kinetic chain, meaning the work done by the feet is accented to compensate. Add greatest bodyweight and then you have even more stress and greater stress leads to trauma of the fascia and pain. Which is why you cannot spot check your plantar fascia and see it as a problem area in isolation. It’s a part of a greater whole and the totality of your movement abilitiy plays a role in what happens to it. And while it may be obvious, it should be noted that the heavier you are the greater burden on your body and the first place to take a hit is your feet. Athletes are not immune to plantar fasciitis; most famously, Hall of Fame quarterback Peyton Manning and his brother, Eli Manning, both sufffered from plantar fascia tears during their careers as reported in ESPN.
Treating Plantar Fasciitis
Rest – take the pressure of your feet. No standing around or running or jumping. In some cases, you can substitute with swimming or cycling, all having been shown to reduce pressure on the fascia[1].
Stretch – don’t just stretch your feet, but work on your ankles and calves. Stretching reduces the pain that comes with plantar fasciitis as long as it is specific to the area.
Wrap Up Well – if you have a particular bad case of plantar fasciitis and see a podiatrist, you will probably get taped up. There is an art to it because you have to position the foot properly but taping provides a tremendous amount of relief.
Ice Up – 10-20 minutes a time, 2-4 times a day. It’s good early on in your recovery but may have diminishing returns further down the line.
Foot Supports – arch supports or wearing shoes with extra support in the arch provide relief. Do you need custom inserts? Probably not, but you need support because that’s what the plantar fascia would be doing by itself if it were healthy: providing arch support.
Night Splints – wear a special boot at night to keep your foot flexed and prevent overnight tightening. It can be up to 3 months before you stop using one but they are effective
Strength Training – you may want to think about loaded carries when you are recovered or doing more of them as a preventative measure. They are a good combination of static and dynamic support in the feet.
The objective of these recovery suggestions are non-invasive. You can, if it gets serious, look at everything from corticosteroid injections and stem cell therapy to surgery, but for most sufferers it’s going to come down to the basics. We often take for granted basic movements like running and jumping, particularly as we age, not realizing that even the simplest movements require complex interactions. We definitely don’t show our feet enough love in the gym because we don’t think of them as a source of power but our connection to the ground or a platform is the single point of focus for major forces whether you are pushing off or doing a squat. Like Bob Takano said, it starts at the bottom of your feet.
Reference:
- Hasegawa, M., Urits, I., Orhurhu, V., Orhurhu, M. S., Brinkman, J., Giacomazzi, S., Foster, L., Manchikanti, L., Kaye, A. D., Kaye, R. J., & Viswanath, O. (2020). Current concepts of minimally invasive treatment options for plantar fasciitis: A comprehensive review. Current Pain and Headache Reports, 24(9), 55.
- Riddle, D. L., & Schappert, S. M. (2004). Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: A national study of medical doctors. Foot & Ankle International, 25(5), 303–310.
-
Goldmann, J.-P., Sanno, M., Willwacher, S., Heinrich, K., & Brüggemann, G.-P. (2013). The potential of toe flexor muscles to enhance performance. Journal of Sports Sciences, 31(4), 424–433.