I came to the sport of running later in life, mostly because the stress of having two children in quick succession took a toll on my physical and emotional health. After joining a local couch to 5K program, I quickly made mum friends who shared my obsession with pounding the pavement in an effort to maintain my sanity.
Over the years, though I’ve suffered a variety of sports-related injuries as I’ve trained for road races, it was my battle with one particular injury that was a game changer for my running career.
Two years ago, after what felt like a routine run with my husband, I started to notice a nagging pain in the arch of my left foot. At first, I tried resting my foot, decreasing my mileage and icing after every run. After a period of weeks, though, the pain became steadily worse and, on the day I stepped out of bed and it felt like a pane of glass had shattered hot sparks of molten lava in my foot, I knew I needed to seek medical advice and treatment.
I was diagnosed with plantar fasciitis (PF), an inflammation of the long stretch of tissue that supports the arch of the foot. Though the heel is designed to withstand the pressures we put on our feet every day, overuse and strain can cause those ligaments to become inflamed. The result is crippling pain in the arch area of the foot.
And, if you’ve ever met someone who has been afflicted with PF, they’ll tell you straight up that it’s a special kind of hell.
According to UpToDate, plantar fasciitis occurs more frequently among runners. Although evidence is limited, possible factors that increase the risk in this group include:
Excessive training (particularly a sudden increase in the distance run)
Improper running shoes
Running on unyielding surfaces
Prolonged standing or walking on hard surfaces
It took almost a full year for my foot to heal from PF and before the residual pain completely went away. If you are suffering with plantar fasciitis, you have my whole hearted sympathy. Here’s what I learned during my own treatment process about the best ways to mitigate the pain and set yourself on the road to recovery:
Don’t skimp on your running shoes and splurge on orthotic inserts
One of the easiest things you can do to try to alleviate the pain of PF is to be properly fitted for your running shoes. While it might seem like a good idea to buy your shoes on sale at a big box store, research small running shops in your community. Often, the employees at smaller stores are more familiar with local terrain and are very knowledgeable about shoe construction and which brands of shoes might offer better support. They can help you pick the right shoe for your size, weight and foot needs. Expect to pay about $200 for a good pair of running shoes.
With plantar fasciitis, a properly fitting shoe is crucial for not only healing but also prevention of symptoms. Features that tend to help are a higher heel, good arch support, and a stiff toe region. And, adding arch support in the form of orthotic inserts could make a huge difference in how quickly your foot heals.
Orthotics are available in sports shops and you can also purchase custom inserts from a podiatrist. Orthotics can run about from $50 at a specialty running shop to $500 for custom inserts. Your best bet is to talk with your doctor or running professional to determine what your best options are when it comes to choosing an orthotic.
By now your regular workouts are as second nature as breathing or wearing pants before you leave the house, but now something — an extended family holiday or an injury perhaps - has ripped away your routine from you. Not working out for a day already makes you antsy. Not working out for a week or more? Oh, no, panic!
Steroid injections will make the pain go away but won’t fix the problem
After about two months of constant foot pain, I finally broke down and went to a podiatrist for a full evaluation. I had heard from other PF sufferers that corticosteroids injected directly into the area of the affected area of the foot could lessen symptoms and aid with healing. And, though my doctor did inject my foot, it was only after I agreed to participate in physical therapy, commit to regular stretching and wear proper shoes on runs.
Injections are usually the fastest way to reduce inflammation and break the pain cycle, says Ann Anderson, a podiatrist at Allentown Family Foot Care. “Injections are usually used in conjunction with stretches, ice, supportive shoe gear, custom orthotics and sometimes with PT and night splints as treatments,” says Anderson. “Surgery is always a last resort for recalcitrant cases.”
Anderson adds that it is important to treat both the pain and inflammation as well as the foot mechanics for the best outcome.
Physical therapy is painful but worth it
Along with steroid injections and stretching, my doctor ordered physical therapy to aid in my healing. “I find physical therapy most helpful for pain along the fascia itself or for patients with a tight plantar fascia band,” says Anderson.
Twice a week for three months, my physical therapist not only walked me through a series of exercises designed to release my ligaments but he also massaged my foot with a tool called a Graston. Basically, it looked like he was smoothing my foot down with a giant butter knife. It was painful as hell but, slowly, my foot began to heal.
Physical therapy was a long, tedious road but those sessions helped me learn how to properly care for my body long term. Bryan Bartz, a physical therapist in New Jersey says, “The main goal of physical therapy is to return patients to the activities they enjoy sooner with long term outcomes and function. Physical therapy also educates the patient on proper management for long term outcomes.”
Get ready for stretching, stretching and more stretching
Ever since I was sidelined by PF, stretching has become a necessary part of my running routine. I had never focused much on stretching my calves and legs before my injury. Now, I stretch before, during and after my runs because I know it will save me from months of pain.
Simple stretches like sitting in a pike position on the floor with a towel wrapped around the base of your foot and pulling your foot gently towards your knee or stretching your calves while pushing on a tree can go a long way in keeping your foot injury free from PF.
Some cases of plantar fasciitis can be complicated to treat
For some, rest, icing, stretching and physical therapy might not be enough to relieve and heal the symptoms of plantar fasciitis. Other more aggressive treatments like splinting, medical taping to the affected part of the foot, surgery and even shockwave therapy might be ordered by your doctor, depending on the severity of your injury.
Unfortunately, plantar fasciitis doesn’t go away overnight. In fact, in an article published in American Family Physician, Craig C. Young, an associate professor of orthopaedic surgery for Medical College of Wisconsin, states, “Unfortunately, the time until resolution is often six to 18 months, which can lead to frustration for patients and physicians.”
But he notes that if you catch it early, that time period may be shorter and you may also be less likely to need invasive treatments.
During my bout of plantar fasciitis, running regularly was excruciating so I had to find other lower impact ways to exercise. I took up barre classes and spent time swimming laps at our local pool to stay in shape. While plantar fasciitis was frustrating and painful, the experience taught me to be kinder to my body with stretching and to never forget to go the extra mile with the proper running shoes for my feet.