So a few weeks ago I wrote and one of the most common causes of pain and discomfort I’ve come across in my military athletes: Shin Splints.
Today I’d like to take a few minutes and talk about another super common injury I run into every day, something that is literally crippling to people and keeps them from not only performing well but from getting out of bed in the morning!
I’m talking about Plantar Fasciitis.
As one of the most common causes of heel pain (I’d say of foot/heel pain in general) Plantar Fasciitis is something I know a ton of you guys are dealing with or have dealt with in the past. And it’s no fun.
Let’s knock out some basic definitions first so you have a better understanding of what I’m talking about.
Plantar Fasciitis is basically a stabbing pain, that is typically much worse in the morning, that is caused by swelling and inflammation of the Plantar Aponeurosis (Fascia).
So basically, when the soft tissues surrounding your foot, heel, and ankle get angry they may tighten up (Way more than a sore muscle) and cause all kinds of fun pain.
The good news is that once you get those tissues warmed up and moving the pain typically subsides a bit.
The bad news is that unless you treat the root cause of the problem the pain will come back and you’ll be dealing with issues for a while.
Quick Disclaimer: I’m not a doctor & I don’t play one of TV. This article is for educational purposes only and if you DO have an injury or problem go seek competent medical advice (If you can find it!)
Who gets Plantar Fasciitis?
Plantar Fasciitis is super common in a few different populations.
First, people who run a lot are typically at the highest risk because of the stress and strain put on the feet while running.
If you think about the force being absorbed by each foot as you run (>2.5x Bodyweight) and you consider this is happening at a rate of around 330 times per 400m (1/4 mile) then you can see that the stress can add up super fast!
Second, if you ruck a lot then you may have dealt with this as well. With the added weight of the ruck combined with the heel to toe motion of walking/rucking your feet take a lot of punishment.
Third, if you’ve recently jumped on the minimalist shoe train (you should if you haven’t, at least in your training) you may have noticed a significant increase in foot, ankle, and calf stress / soreness.
This is exactly why I suggest people transition into a more minimal shoe over the course of months and not days. You body will adapt but it takes time to safely gain & use that new range of motion.
Additionally, anyone who spends a ton of time on their feet, jumps rope a ton (Practicing your double-unders like crazy?) or significantly increases their physical activity (from their normal baseline) could be at risk.
Since Plantar Fasciitis is basically a result of over-stressing the tissues of the foot and lower leg anyone who makes a significant change to the amount of stress they are placing on the feet and lower legs can run into issues.
How do I avoid it (Or not make it worse)?
So now that we know that the primary cause of this all too common injury is over stressing the tissues of the lower leg and foot the best way to avoid it is to make sure you are not over-stressing those tissues!
Pretty simple huh?
But what does that really mean to me?
Basically, it depends on your current physical condition and previous training history but just about everyone can benefit from one simple thing:
Improve the mobility and flexibility of your feet, ankles, and calves.
If running less is not an option (because of mandatory PT or whatever) then the absolute most bang for you buck will come from spending a significant amount of time stretching and mobilizing.
For more detailed info on this I’ll point you to someone WAY smarter than me with these videos:
Plantar Fasciitis – Dr. Kelly Starrett – Mobility WOD
Free Your Calcaneus- Dr. Kelly Starrett – Mobility WOD
Ultra Runner’s Feet
Mobility work is great, but how about strengthening the foot as well?
As you may have noticed in the first video above Kelly mentions that a ton of stress on the foot comes when the arch is allowed to collapse medially (towards your other foot).
When this happens you put a ton of stress on the tissues in your foot as well as over stretching the muscles of the lower leg in general. This pattern is a super common movement dysfunction, especially in folks who spend the majority of their days sitting.
The glutes get turned off and stuck down and all kinds of stuff goes wrong downstream.
This is something I addressed in the Shin Splints post I mentioned before. That medial collapse of the foot and ankle, typically due to a lack of strength & stability in your glutes / external rotators, can also cause plantar fasciitis.
So if avoiding shin splints didn’t get you excited about squatting and lunging more hopefully this will!
Best way to avoid this medial collapse?
Strengthen those glutes with stuff like squats, step-ups, hip thrusts, single leg deadlifts, and lunges.
If needed, take your shoes off and pay close attention to your feet during these exercises. Try your best to maintain an arch in your foot throughout the entire range of motion!
If that seems impossible then reduce the intensity (less weight, volume, more rest) and try again.
Personally, since most of my workout programming is heavily focused on building strong and durable hips, glutes, and legs I like to warm up and cool down with a few minutes of barefoot jump rope for a little extra conditioning of that foot, calf, and ankle complex.
Try this in your next warm up: 5:00 of barefoot jump rope
The goal of this should be continuous movement. If you’re comfortable jumping rope then feel free to mix in single and double footed jumps, double-unders, and running in place.
I think you’ll notice that it is much harder than it sounds!
Wrapping it up
Once again we see a super common injury that is entirely preventable by identifying the specific movement deficiency FIRST and then addressing that.
So it should be no surprise that the term ”Movement Impairment Syndrome” is synonymous with the term “musculoskeletal disorder”. If you can’t move correctly, you’re gonna end up with some sort of musculoskeletal disorder or injury!
All of those common remedies like ice, heat, and ibuprofen only serve to treat the symptoms and do absolutely nothing for the underlying cause of the problem.
You need to identify and correct the specific movement dysfunction first!
So while plantar fasciitis can be super debilitating you should know that it can be fixed by allowing the inflammation to clear (rest, compression, movement, elevation will help) and then focusing on the root cause:
Your tissues are too weak and you’re probably in a bad position.
A solid strength & conditioning program combined with some aggressive mobility work is likely all you need.
Sahrmann, S. A. (2002). Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis: Mosby.