•  Foot Problems & Care •  How to Choose Running Shoes

You've probably strained your plantar fascia. That's the tough, fibrous tissue that connects to the base of your heel bone and runs along the bottom of your foot, encasing the muscles that curl your toes and help support your arches. Plantar fasciitis (fash-ee-eye-tis), an inflammation of the fascia, is one of the most common and persistent injuries among runners.

Running in wornout shoes, increasing your mileage too fast, being on your feet too much, being overweight -- all these things can cause your feet to pronate, or roll inward, flattening your arches. Pronation strains your fascia and causes tiny tears in the tissue, which then becomes inflamed. When you sleep or rest, the tissue shrinks a little as the foot relaxes back into its natural position (toes somewhat pointed). In the morning as you get out of bed and press your feet to the floor, your arches collapse and stretch the fascia, and the cycle of pain and injury starts all over again. The pain may decrease as you walk around and the fascia stretches out, but it will return after you rest. You're particularly vulnerable if you wear high heels a lot, which shortens your plantar fascia, or if you have flat feet, high arches, or tight calf muscles.

Stay off your feet as much as possible, and avoid walking barefoot, even to go to the bathroom during the night. Try wearing arch-supporting sandals like Birkenstocks, and put drugstore arch supports in your athletic shoes. Roll your feet over frozen-juice cans for ten minutes three times a day to reduce the inflammation. And strengthen the muscles that support your arches by picking up a golf ball or scrunching a towel with your toes. Also, stretch your plantar fascia at least three times a day, starting first thing in the morning. Here's how:

•Loop a towel around the bottom of your foot and pull your toes toward your nose for 30 seconds, three times in a row. (Do this one before you even get out of bed.)

•Stand facing a flight of stairs with your feet on the lowest step, and your heels extending out beyond it. Slowly lower your heels below the level of the step. Hold for a count of ten, rest, and repeat ten times.

•Do three sets of ten wall push-ups with your legs straight and then bent, barefoot if possible.

Many doctors also recommend that you wear night splints (you can get them from an orthopedic-supplies store) or sleep in stiff, high boots (ski boots work best if you can stand them) to hold your feet flexed and stretch your fascia as you sleep. It may be awkward, but it's effective. To keep in shape or take off excess weight, turn to low-impact activities like swimming and biking. Don't begin running or walking for exercise again until you've been free from pain for at least a week. When you do, start slowly, increase your mileage gradually, and ice your heels afterwards. Don't try to run through the pain; the longer you wait to care for this injury, the longer it will take to heal. Most people need about six months to recover from plantar fasciitis once they start treating it.

When you have to be on your feet, wear shoes with plenty of support and cushioning (you can buy arch supports with heel cushions for your street shoes if you can't wear athletic shoes) and take anti-inflammatory painkillers like aspirin or ibuprofen. Some people get temporary relief from acupuncture as well, although it may cause your heels to hurt more for a day or two after the treatment. Keep in mind that these are only short-term solutions and that the pain will recur until you give your injury time to heal.

If the pain hasn't lessened after a few weeks of rest, icing, and stretching, or if you start to feel numbness or tingling in your heels, make an appointment with an orthopedist or a podiatrist. A doctor may take an x-ray to make sure you don't have a stress fracture. He can fit you for night splints and orthotics (custom-made arch supports that can be very helpful), and might recommend physical therapy as well. If you are really in pain, he may give your a cortisone injection to reduce the inflammation temporarily, but repeated injections can weaken the tendon and cause it to rupture. Almost everyone finds relief from plantar fasciitis within a year if it's treated properly. As a last resort for people who don't, some doctors may recommend surgery to sever the plantar fascia from the heel bone, but this technique is rarely used and can cause more problems than it solves.

Throw away your high heels and old athletic shoes. Buy new walking or running shoes with good arch support (you may need inserts or orthotics, too) and with a stiff heel counter (the part of the shoe that surrounds your heel; it should fit snugly so your heel doesn't slip up and down). Replace your shoes every 300 miles (every 15 weeks if you walk or run about 10 miles per week). Better yet, buy a new pair every 150 miles and alternate them with the current pair. Check your shoes for wear periodically by putting them on a table and looking at the backs. If the soles are worn at an angle, it's time for a new pair. Avoid running or walking on beaches, concrete sidewalks, steep hills, or sloping streets. Instead, choose grass or dirt trails if you can. Increase your mileage by no more than 10 percent a week. Always warm up and stretch your feet before you exercise, and then stretch again afterward. If the pain returns, ice your heels and cut back on your activity.

-- Kate Lee is a former associate editor at Consumer Health Interactive and researcher at Time Inc. Health. She is currently a senior editor at BabyCenter.

Further Resources

American Podiatric Medical Association

http://www.apma.org

References

First published April 1, 1999
Last updated October 31, 2007
Copyright © 1999 Consumer Health Interactive

Or Find More On:

Back to top of page