RW: What causes plantar fasciitis and why is it such a problem for runners?
CG: Plantar fasciitis involves inflammation of the plantar fascia, a thick, inelastic band of tissue that runs across the bottom of the foot and connects the heel bone to the toes, Mendeszoon explains. “The impact of running puts incredible stress on the foot; during heel strike, up to eight times a person’s body weight is absorbed by the foot. Because the plantar fascia is not very forgiving and does not stretch, these repetitive forces cause micro tears at the point where the heel bone connects. “To run a mile, the average person will take about 1,500 steps,” Mendeszoon explains. “So the best analogy for the repetitive forces that cause plantar fasciitis is like picking a scab which continues to cause little bleeding and therefore more scab or (scar tissue) – which is even more inelastic than the tissue of origin.”
RW: Can the wrong shoes exacerbate plantar fasciitis?
CG: “Shoes have a huge impact,” says Mendeszoon. But there’s also no single answer for which shoes to avoid. “Like fingerprints, everyone has a unique running shape and gait cycle, or the way the body moves from step to step,” he says. “It’s important that runners are assessed by a professional who works at a local running store so they can be assessed and matched to the right running shoe for their body type, foot type, running activities and their goals.
RW: What is the best way to treat plantar fasciitis?
CG: The unsatisfactory answer is that there is no simple remedy to treat plantar fasciitis, according to Mendeszoon. But there are ways to ease the pain and help your foot heal. “The best treatment is to start with proper running shoes or walking shoes to provide support and cushioning to your foot,” he says. “Avoid walking barefoot as much as possible. Start working on flexibility and Achilles tendon stretching exercises. The majority of people with plantar fasciitis usually have a tight Achilles tendon, so it is essential that they stretch the Achilles tendon several times a day, every day.
You will also need to avoid running and other high impact activities. And be prepared for the ice cream to play a big role. “Ice the bottom of the foot twice a day for 15-20 minutes, take ice baths twice a day for 10-15 minutes, or take Dixie cups filled with water, freeze them, and use them to massage your heel for 10 minutes. 15 minutes several times a day,” he says.
You can also take an anti-inflammatory like ibuprofen two to three times a day, if you’re healthy, but don’t take it long term. And if the condition does not improve, see a doctor who specializes in sports medicine and foot care. “Generally, doctors will treat plantar fasciitis with the above methods, but also add physical therapy, medication, a night splint, a walking boot, and possibly even injections,” Mendeszoon says. “Very few people with plantar fasciitis actually need surgery, but that decision will be based on the doctor’s opinion.”