Foot and the arch of the feet need to have special attention especially for runners. As well as being a common sporting condition, plantar fasciitis is perhaps one of the most debilitating. Plantar fasciitis is a condition that results in pain under the heel and/or into the arch of the foot.
The plantar fascia is a broad, fan shaped structure that acts as a bow string for the bones of the foot, thus maintaining the arch of the foot during weight bearing. It is reinforced by the tendons of muscles tibialis posterior and calf/Achilles . These structures may be subjected to unfamiliar or repeated, abnormal stresses that results in small tears, and ultimately inflammation, scar tissue and pain.
Pain frequently commences for no apparent reason. Initially, there is pain first thing in the morning or after arising from rest. With sport, the pain often subsides once the athlete is warmed up, only to return when cooled down. Eventually, the pain becomes so severe, that weight bearing without limping is impossible.
A thorough assessment and diagnosis by a Physiotherapist is essential to formulate a specialized programme for each individual.
1) Foot Mechanics
- flat feet (over pronation) may result in repeated over stretching of the plantar fascia, thus increasing stresses on the arch.
- Inadequate arch or medial support in running shoes, allowing the foot to roll in further, thus increasing stress on the arch.
- Prolonged standing, walking or running on hard surfaces increases the shock having to be absorbed by the arch of the foot.
- Heel spurs. This will occasionally be seen on X-ray, but in itself, is not always the source of pain, more over, an incidental finding or the body’s response to the chronic inflammation of the plantar fascia.
2) Training Factors
- A rapid increase in training distance.
- Incorporation of hills into training.
- incorporation of sprint work into training.
- Frequent running on slopes (road cambers)
3) Tight Calves
- feet pointing forwards
- back straight
- lunge forwards with knee bent
- heel remains on ground
- Same position as soleus but knee is straight