running injury
Picture this, you wake up early in the morning, rub the sleep out of your eyes, sit up to get your day started, you already smell the coffee that you programmed last night. All is right in the world, but when you put your foot down for your first step AAACHH!
It feels like you've stepped on the sharpest Lego piece imaginable, except there's no Lego (I have a 6 yr old & 4 yr old, both boys so there's always Legos).
You've been told by your neighbor, doctor, Google and your twice removed cousin on Facebook that you have plantar fasciitis (PF). Which makes sense, because plantar fasciitis is the most common type of foot pain. Nearly 10% of people will deal with PF at some point in their life and roughly 15-20% of ALL foot pain can be attributed to PF. But how do you know if YOUR foot pain is PF or not? Knowing the distinction can make a world of difference with treating and FIXING your foot pain.
My goal with this post is to give you a brief guide on what PF is, how you can diagnose it yourself and practical tips for how to treat your foot pain. I'll even include some videos of day 1 exercises that you can do to get started on treating your plantar fasciitis. If you haven't already noticed I'll be referring to plantar fasciitis as PF because spelling it out is a lot of characters and I don't want to spell it out 100 times.....soooo LET'S GET TO IT!
What Even is Plantar Fasciitis
It All Starts at the Heel
The plantar fascia is a thick fibrous band of tissue that connects your toes to your heel. This structure is what makes up the "arch" of your foot. Usually anytime you see "itis" that is going to refer to inflammation, or irritation. In the case of PF it's more accurately referred to as a degenerative issue and not an inflammatory issue. The term "plantar fasci(ITIS)" doesn't accurately describe what PF is, but it's a term that has become common in our everyday language. Pain associated with TRUE PF is usually a result of degeneration of the collagen fibers within the fascia where it connects to the heel bone (calcaneus). This is what produces the HALLMARK sign of pain at the heel on the bottom of your foot.
Other important distinctions that can help you understand if you have PF or not include:
- Heel pain with your first step in the morning, or after rest
- Improved pain with movement
- Pain returns at the end of the day
These symptoms are common with other types of foot pain, but the real differentiator is that classic SHARP heel pain, especially with the first few steps in the morning or after a period of inactivity.
Do What the PT's Do.
The most common test that you'll see a physical therapist do to determine if you have PF or not is the Windlass Test (click those blue words, it'll show you a video). All you have to do is simply grab your big toe and bend it towards your shin. If doing this recreates that sharp heel pain, there's very good odds that your pain IS in fact PF.
PRO TIP to make this test even more gooder (official clinical term), have someone else bend your big toe towards your shin while you are standing straight up.
Other things you could expect a PT to look
- Calf tightness
- Arch height,
- Overuse issue that resulted gradually vs traumatic and began immediately following a specific event.
- Things that make it feel better/worse
If these symptoms sound like you, you might be dealing with PF. if it doesn't, well it's probably not PF. But keep reading anyways!
Time for the GOOD STUFF. Physical Therapy
As previously stated, if you want to wait it out, PF will usually resolve itself within....years.
With PT you can typically expect PF to resolve itself within weeks to months.
A combination of foot/calf strengthening as well as stretching will do *WONDERS* for reducing your PF pain. Manual therapy is also very beneficial for reducing pain associated with PF.
Dry Needling of the calf muscles as well as in the heel where your pain is can be very beneficial for improving pain levels and function. This can be a very useful option before you venture into more invasive treatment options.
Doing these things in combination with brief activity modification is going to be the best way to reduce your heel pain quickly.
People tend to go with passive measures (think massage, dry needling, injections etc) but active measures are usually going to provide the best results, and PF is the same. Exercises and movement based treatment are going to be the best solution for resolving your PF.
For those of you who skipped to the bottom to get the exercises here they are!
These are 4 general exercises I typically prescribe to help my clients who are dealing with PF pain. This is a good place to start, but as with anything progressive exercises that continue to get more challenging will yield the best results.
Lunging PF Stretch
Self PF Stretch
Calf Stretches
Deficit Heel Raises
I'm a Physical Therapist by trade and this is my bread and butter. If you've been dealing with plantar fasciitis (or any other type of pain). I offer FREE Discovery Calls (click the blue words to see my calendar)
My goal is to help you make the most informed decision you can with your health.
(Did I mention it's free?)
-Dr. Stephen Mayo, DPT
