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Plantar Fasciitis

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Plantar fasciitis – that pain in the heel 

By Doug James – Podiatrist and Physiotherapist – intraining Running Injury Clinic


A lot of runners fear stress fractures. Sure they are painful and can prevent you from running for 6 or more weeks while they heal, but this is a relatively short period of pain compared to some injuries. In fact, there are particular running injuries that commonly last for well over a year. One of the more unpleasant of these long-term injuries is Plantar Fasciosis.  


Well, I’ve heard of Plantar Fasciitis before… 

Plantar Fasciosis (pronounced “Fash-ee-oh-sis”) is the more medically accurate term for chronic Plantar Fasciitis (“Fash-ee-eye-tiss”). Plantar Fasciitis is a painful injury to the Plantar Fascia which is found in the sole of your foot. The injury often begins after the Fascia is overloaded beyond what it’s capable of handling, and a strain or small tear may occur. The body tries to heal this, and in many cases successfully, but it becomes “chronic” if it hasn’t healed within a few weeks of onset and begins to develop certain changes within the tissue (discussed later). In the more acute “Fasciitis” phase you may feel moderate to strong pain that is often worst when first standing after sleeping or prolonged sitting. For a majority of cases the pain will be located where the arch meets the heel bone (calcaneus), but is occasionally felt along the arch or outside part of the foot. 


So, what does the Plantar Fascia do? 

The plantar fascia is a long piece of connective tissue, much like a tendon, that runs from your heel bone towards your toes. It provides important structural support when standing, and along with the Achilles tendon it absorbs impact force then assists with creating propulsion for push off.  Given the location and importance of the fascia, it can make life quite unpleasant when it is sore.  


Why did it happen? Why me? (It isn’t fair).  

It’s not well understood what causes Plantar Fasciosis, but there are a number of risk factors for its development. With around 10% of the general population likely to experience Plantar Fasciitis, this rate is closer to 18% in runners – and it is likely due to the impact that is experienced in the foot while running. It is more likely to happen if there has been a notable increase in the activity level undertaken recently, and if the shoes are inappropriate (wrong style, and/or worn out). In the general population Plantar Fasciitis commonly strikes if people do a lot of walking in unsupportive shoes (or barefeet) as often happens during a holiday at the beach. In the running population, Plantar Fasciitis may develop if someone has increased their training volume or intensity too quickly, and/or are running in worn out shoes. In general, females tend to be more likely to develop Plantar Fascia injuries, and it is more common between 40-60 years of age as our connective tissue repair is less effective.  


I’ve had it for months, will it ever get better? 

This is a really common question. While it may feel like it may never get better, studies show that most cases (95%) will resolve within 18 months. This may seem like a really long time, but should offer some hope, especially as the pain tends to diminish in the later stages of the injury.

How do I make it feel better? 

The 3 main goals once the acute phase has passed are to manage any pain flare ups, rehabilitate your foot, and avoid irritating it further. Flare ups can occur if inappropriate footwear is worn (usually unsupportive or worn out) or if too much activity has occurred.  Ice packs and pain relief medication can be helpful for managing flare ups. Rehabilitation requires a personal assessment to determine causative factors. This should  involve some sort of strength exercises, identifying any footwear issues, and if orthotics are needed. Avoiding flare ups / irritating your injury usually involves making sensible footwear choices. Intraining is now stocking a number of great products that can assist with managing Plantar Fasciosis. Slides and sandals from Oofos, Hoka and Lightfeet are invaluable for wearing around the house, casually or to the beach. They each offer a comfortable amount of cushioning with the different brands each offering a different amount of arch support.  


Strapping tape can help provide excellent short term relief, but if you aren’t able to tape your foot (allergic to it, or find it difficult to do) wearing Feetures Plantar Fasciitis relief socks provides a good alternative.  


While Plantar Fasciosis can be a long lasting injury, it needn’t get in the way of your running goals. A thorough assessment can help to accurately diagnose your injury and get you back on track sooner, and with less pain. For a personal assessment and personalised treatment plan of your heel pain, or other injury, contact the intraining running injury clinic today. Ph: 07 3367 3088.

Doug James Colour 2020

Doug James – Podiatrist and Physiotherapist – intraining Running Injury Clinic

Doug James is a qualified physiotherapist and podiatrist with a special interest in running and sports injuries. He combines the two treatment approaches to achieve successful outcomes for clients of all abilities from non-athletes to elite athletes.

Bachelor of Podiatry (honours), Master of Physiotherapy Studies.

Doug has undertaken further training in dry needling, Pilates, and Rocktape and may incorporate these as necessary during treatment.

Doug is also a keen runner having completed the New York Marathon.