Plantar fasciitis

The symptoms

Nasty pain in the bottom of the foot, especially when running or even taking your first steps out of bed in the morning.

What’s going on?

Plantar means the bottom of the foot, and its fascia is the band of connective tissue running from your heel bone to the front of your foot. This tissue helps support your foot’s arch and gives it shape, and it aids in stability when your foot strikes the ground and then pushes off. So, plantar fasciitis is basically inflammation of the plantar fascia.

An injury to the fascia usually begins where the fascia connects to the bony bump on the bottom of the heel called the calcaneal tuberosity. The inflammation and pain come from excessive tension. The muscles above, and the shape of the foot below, contribute to its development. The calf muscles (specifically, the gastrocnemius and soleus) connect to the heel bone via the Achilles tendon. When those muscles are tight, the tendon pulls on the bone from above, stretching the fascia and causing strain. People with high arches are especially prone to plantar fasciitis because the arch itself also contributes tension to the fascia.

A mild case can turn major very quickly. Inflammation makes the fascia more prone to microtears, which can lead to debilitating pain – so you can’t walk, let alone exercise. Bad cases can last months and could potentially sideline you for almost a year.

Fix it

Employ dynamic rest: Take a break from the offending activity. The earlier you address plantar fasciitis, the better. How long you need to rest depends on the severity, but expect at least a couple of weeks. Stick with intense upper-body activity that doesn’t load your foot. This may be frustrating, but it’s better than being out of the game for months. Stretch: Use the stretches described in ‘Prevent it’ (below). Be gentle. Go slow. You’re trying to relieve the tightness in the area, not prepare for a game or race. As the injury heals, adopt this stretching routine permanently.

Try an NSAID: An antiinflammatory such as ibuprofen or aspirin can help reduce pain. Consider splints: Foot splints are available (try physioroom.com, £24.99) and can help if worn at night. It’s best to have a doctor recommend one, though, as there are several varieties.

Ease yourself back into the game: Don’t restart strenuous lower-body activity until you’re pain-free.

You’ll just aggravate the injury and be out even longer.

Prevent it

Stay flexible: Put your toes and the ball of your foot against the top of the vertical edge of a step with your heel on the floor and slowly lean forwards, keeping your leg straight, until you feel the stretch at the top of your calf. Repeat with your knee bent, feeling the stretch farther down the leg. Hold each stretch for 15 to 20 seconds and repeat several times in each position. Do this daily, before and after exercise.

Roll it: A simple preventative measure you can do anywhere, even sitting at your desk. Roll a tennis ball back and forth under each foot for a few minutes a day. The ball massages and loosens the fascia.

Try orthotics: Over-the-counter (OTC) arch supports can be helpful, especially for high-arched runners. Prescription orthotics are another option – they are custom-made for your foot – but try the (much cheaper) OTC orthotics first and if they don’t work, see a podiatrist.