If you are currently suffering (or have ever suffered) from excruciating heel pain known as plantar fasciitis, you also know it isn’t easily remedied. Marissa Oachs, a certified and licensed athletic trainer, offers tips for preventing and caring for plantar fasciitis. Thanks for blogging for me today, Marissa!

Plantar Fasciitis

What is it?

Plantar Fasciitis (plantar fash-ee-eye-tis) is a common problem both among athletes and non-athletes. Let’s first talk about what the plantar fascia (the cause of all these problems) is. The Plantar Fascia is a thick bundle of fibrous tissue that starts at the heel and ends at your toes. It assists in maintaining the stability of your foot especially when landing.

Causes

So what causes this condition? Well, unfortunately a lot of different things can lead to this condition – tightness of calf muscle, wearing shoes without sufficient support in them, running on soft surfaces, different leg lengths, tightness of arch of foot, and lengthening your stride too much while running. Now most of these causes can be fixed or altered to help plantar fasciitis and we will talk about that later.

Signs you may have it

Signs of this are very clear because most of the time – it is very painful! You will feel pain in the heel and it will spread down into the middle of your foot. It is marked by being particularly painful and bothersome in the morning when you get out of bed or when putting weight on your foot after sitting for a long period of time. However, as you walk a little ways, the pain will lessen. You can also test for this condition by pulling your toes and foot toward you (see Picture 1 below in stretching). If this elicits a lot of pain, this will usually point towards Plantar Fasciitis because you are stretching the aggravated plantar fascia.

Care

Keep in mind that you cannot nor will not fix this condition right away. It takes time for it to heal and also to fix the causes. It is not uncommon for it to take as long as 8-12 weeks for this to completely heal and symptoms to stop. It is especially hard to fix because it is a body part you most likely use fairly often. This slows down the healing process. Now that the depressing news is out of the way, on to the encouraging news of how to fix it! You will need to refer to the pictures to see how to do specific exercises.

REST: The first step you always want to take with an injury is rest. This is the only way the injury will get better. I know, I know. It is your foot. You must walk on it to get around. Well, seriously you may need to get some crutches. If it is so bad you must limp around, you need to use crutches, because once you start limping, other parts of your body will start hurting and you will have new injuries and have to start this whole process over again. Fun, huh? If you don’t have crutches (or refuse to use them) just try to stay off of it. Do not walk if you don’t have to, keep your foot up and elevated at all times.

STRETCH: This is a big one with this injury. You will want to do this as often as you can throughout the day and for at least 3 sets holding for 30 sec. Always do stretches gently and not to the point of pain. It should (almost) feel good!

Wall/Stair stretch - See Picture to the left. Find a stair or wall and put the bottom of your foot against it. You will feel a pull – do not push too hard – pain is not good!

Do it yourself stretch: If you are too nervous to try the wall stretch, just start by doing it with your own hand. See Picture 1 to the right. You must do it gently and still hold for 30 sec but you can control this one easier.

Picture 1 – Doing this will cause pain if you have Plantar Fasciitis. However, it is also a great stretch

Ball Roll: This exercise may be painful but pain is OK in this exercise because it is helping to break up the scar tissue and knots that have occurred. Find a ball or thick stick (something that rolls) and put it under your foot. Step down on it and roll it under your foot putting as much pressure as you can handle for at least 10 sec. Do it twice. Always do the stretches from above after and ice.

ICE/ELEVATE: You will hear me say these words a lot with every injury. But honestly, it will be your best friend. Ice the first 72 hours at least. Ice and elevate your foot at least 20 min at a time and do it as often as possible. Do it for sure after you do the exercises from above – because you will get sore!

IBUPROPHEN: Take as prescribed to relieve pain and swelling.

ORTHOTIC: Go to the store and pick out a cushion for your shoe. If this doesn’t work to relieve pain/symptoms you may need to go see a specialist to get a custom orthotic made.

PREVENTION

1) Buy good quality shoes – especially if you are on your feet a lot and/or exercise a lot. You should always give your shoes a 24 hour break for the cushion to re-cushion itself/spring back. So it is a good idea to have two pairs that you switch off each day. The sales people are usually pretty good at stores about knowing which shoes are good and bad. Ask for help – it won’t kill ya! Also, replace your shoes every 500 miles or so of use.

2) Always stretch – especially the calf/foot stretches I showed above. This will help prevent you from getting it again.

3) Maintain a healthy weight – this will help minimize extra stress being put on the foot and the plantar fascia itself.

4) Choose your footwear (or lack of footwear) wisely – Ladies: avoid high heels! Everyone – try to avoid going barefoot, especially on hard surfaces. All of these cause extra stress on your foot’s support system, a.k.a the plantar fascia.

5) If this injury reoccurs over and over for you, make sure to go get your feet checked out by a professional and look into custom orthotics. Many people have a foot type that predisposes them to this injury and if you don’t cushion your foot right, you will continue to hurt your plantar fascia and other parts of your body.

**And remember, always go and get checked out by a medical professional if home treatments do not work. This article is not meant to be a diagnosis or treatment plan for you or your injury. You must be looked at by a professional to know what is exactly wrong. **

Marissa Oachs is a certified and licensed athletic trainer. She has worked with high school & Division I athletes, but also loves to work with the general population or the “athletes of life”. She loves to help people feel better and stay better! She also loves to play sports off all kind, spend time with her husband and 6-month old son, and write for her blogs. You can check out more about injuries and health in her weekly blog series, “What’s Wrong Wednesdays” in her blog “The Hardest Job on Earth” She also has a blog where she talks about her favorite products and books, “The Review Stew”

Runners, I am SO jealous of you right now! As my injury slowly heals (waaaayyy too slow for my liking), I seem to notice more people hitting the jogging paths. Forgive me if I throw a rock at you as I drive by. ;0)

One thing I have learned through this rather inconvenient pain in my ass (literally), is that less might be is more. I stretched before said injury, but not enough. I went to yoga every so often, but I know it wasn’t enough. It had been some weeks months since I had a “taper week” or really, any light workout at all. My all or nothing attitude got the better of me. And so, here I am, having to heed my own advice. Believe me, it is like swallowing a bitter-tasting horse pill that then lodges in your throat. I’m learning, and passing along to you my plan of attack so that, 1) I’m held accountable, and 2) you can partake in a “less is more” workout if you chose – and actually, I highly advice that you do.

1. More stretching. Every day for me now. 15-30 seconds per major muscle group, plus some smaller muscles that are overworked and under-appreciated: IT band, tops of feet (perorius tertius, also known as dorsal flexors, as if you care, but you might), the soleus (calf muscle), and perorius longus (the muscle that runs down the outside of your lower leg.) My plan: 2 sets of each exercise, 5-7 days/week.

2. Yoga. The once/week deal I had going on was great…when I went. Clearly, I need yoga in my life, and I think yoga needs me. My plan: Ashtunga 2x/week for 60 mins for now. I’d like to get up to 3x/week and have one of those days include Hatha or a yoga/pilates fusion sort of thing. We’ll see where all this goes over the next few weeks.

3. Massage. I have two appointments set for next week, and after than, I’m shooting for once/month. The benefits of massage are so many that I have to send you away from here momentarily to check them all out. Read: “38 ways yoga keeps you fit“, and Please come right back

4. Taper weeks. The body can not handle day-after-day, week-after-week, of hard training. Period. As with any time of periodized program (marathon training comes to mind), you have to balance the building weeks with taper weeks where, literally, less is more. This gives the muscles time to recover and repair. My plan: every 4 weeks, make 2 of my workouts lighter (i.e, less hard).

5. Sleep more. My plan: 8 hours per night! That’s my mantra. I haven’t lived by this rule, and yet, sleep is so important for muscle repair and for keeping cortisol levels in check. And with that note, I’m off to bed!

If you have ever suffered from sciatica, or lower lumbar problems, you understand the excruciating, sometimes immobilizing pain associated with flare-ups. Often recognizable by an acute pain in your derrière that also radiates down into the lower leg, sciatica can cause muscle weakness, tingling, numbness, and of course, wicked pain. According to the American Association of Neurological Surgeons, more than 65 million Americans that suffer from lower-back pain, such as sciatica, will have a recurrence of the pain within one year. (American Assoc. of Neurological Surgeons, 2000.) Therefore, seeking medical attention is the first step toward alleviated that nagging pain, as well as preventing its return.

The sciatic nerve is the longest nerve in the entire body. It runs from the lower back, through the hip and buttocks, then down each of your legs. Its job is to control a variety of muscles in the legs. If a medical professional diagnoses you with sciatica, the direct cause of the problem will often be the first step toward treatment. When you experience sciatic nerve-related pain, the true culprit is actually the pressure being placed on the nerve, rather than the nerve itself. So to alleviate the pain, you must first relieve the pressure on the nerve. Again, good reason to seek a medical professional, who can determine if the pain is caused by spinal stenosis, a herniated disk, injury, or piriformis syndrome. A professional can diagnose the cause based on where you feel the pain. For example, do you feel pain from the lower back to the knee? Or, is the pain along the inside of your calf down to the bottom of the foot? Is your pain tingly, or pins/needles? Based on your feedback, a course of treatment may include physical therapy, yoga, Pilates, stretching, and medication, or a combination of any of these.

Generally, exercises that strengthen the lower back and abdominals, improve posture, and increase flexibility in the hip and knee joints (and muscles surrounding them), are targeted.  Athletes aren’t immune to sciatica problems, especially if their sport causes tightness in the hips and hamstrings. With this in mind, stretching the piriformis muscle, located deep within the gluteal muscles, is good practice for both relieving sciatic nerve pain, as well as preventing it.

Stretch it out!

To stretch the piriformis muscle, start on hands and knees. Bring your left foot in front of your right knee until the outer left thigh is resting on the floor (knee is still bent) and the left foot is under your pelvis.

Slide the right leg back, keeping the thigh toward the floor as much as possible, until the leg is straight behind you. This will look like the splits, but the front leg is bent underneath you.

Beginners: Sit up straight, pull your lower abdominal muscles in as though you are zipping up pants, and using your arms for balance, hold the stretch for 15-30 seconds.

To achieve a deeper stretch, you can lean forward over the front, bent leg, and if possible, place your forearms on the floor in front of the bent leg.

To achieve maximum benefit from this stretch, do 2-3 sets, holding each stretch for 15-30 seconds.

Practice prevention every day.

-  When sitting for long periods of time, be sure to stretch every half-hour to 45-minutes.

-  If you stand for large chunks of time, try placing one foot on a stool to alleviate the pressure on the spine. Switch feet every 15-20 minutes.

-  Make stretching a part of your exercise routine and address muscle tightness as soon as possible with stretches targeting tight/sore areas.

-  Stay active. Inactivity can make back pain even worse.