Common Injuries: Plantar Fasciitis

**Editor's Note: This post launches a new blog series for us on the theme of common injuries. We know this is a huge concern for many runners and walkers, so we're enlisting the experts to enlighten us! 

Plantar fasciitis is a painful condition of the foot involving inflammation of the plantar fascia (aponeurosis), and is one of the most common injuries to the foot. It most often occurs due to repetitive microtrauma to the fibers of the fascia at/near the heel bone. Biomechanically, the plantar fascia provides strong support for the foot during both pronation and supination phases of the gait cycle, allowing the muscles of the leg/ankle/foot to work efficiently during activities such as running and jumping.

The most common cause of plantar fasciitis is overuse or repetitive trauma, and is facilitated by biomechanical factors such as flat feet, over-pronation, a tight Achilles/calf complex, limited great toe movement, and lower extremity weakness. Training errors, such as poor foot wear, large adjustments in training volume, running on a hard/cantered road, excessive hill training, and inadequate rest may also contribute to the condition.

Recommendations to Avoid Injury:

1. Proper biomechanical assessment and footwear.

2. Proper training program and progressions.

3. Stretching: to promote recovery between runs and reduce strain on vital tissues

4. Strengthening: Proper stability throughout the kinematic chain, especially foot/ankle is required to tolerate impact.

5. Technique: Foot impact and cadence

Injury Prevention Activities - Plantar Fasciitis: 

Stretching - Gastrocnemius (calf)

Stand with hands on a wall and one leg straight backward, bending your front leg. Keep your heel on the ground and your knee straight. Hold for 30 seconds. Repeat 2 times on each leg.

Stretching - Soleus (inner calf)

Stand in the same position noted for the Gastroc Stretch, but now bend your back knee, keeping your heel on the ground. Hold for 30 seconds. Repeat 2 times on each leg.

Stretching - Plantar Fascia (arch)

Stand with your toes against a wall and your knee straight in front of you. Lean forward to feel a stretch in the arch of your foot. Hold for 30 seconds. Repeat 2 times on each leg.

Self Massage Roller - Calf

Grab roller with both hands and place middle of roller on calf and roll up and down calf from your ankle to your knee. Repeat 20 times.

Todd J Cruz PT, MS, Director: Northwest Portland Physical Therapy

Todd is a 1992 graduate from Oregon State University (Go Beavs!) and went on to earn a Masters of Physical Therapy degree in 1995 at the Mayo School of Health-Related Sciences in Rochester, MN. He started practicing out-patient orthopedic physical therapy with Therapeutic Associates in 1995 with an emphasis on spine care using exercise and manual therapy techniques. In 1999, Todd became Director of NW Portland Physical Therapy, and while continuing with spine and general orthopedic care, his practice increased emphasis on working with local high school and recreational athletes. Todd has worked with cyclists and triathletes since 1996, performing bike fitting to improve their comfort/efficiency/power on the bike.