Still Can’t Run Because of Foot Pain?
Solving the Challenge of Chronic Plantar Fasciitis
By Dr. Jerry Yoo Founder, Next Level Physio
6-Minute Read
Key Insights:
- Discovering the underlying root cause(s) of your plantar fasciitis is crucial for achieving lasting relief.
- Understand why conventional physical therapy may not be solving your plantar fasciitis.
- How your running form can significantly impact your plantar fascia, recovery, and return to running.
As the marathon season hits its stride, I'm reminded of the unique challenges faced by runners and lifelong athletes over 30. At Next Level Physio- Cary location, we're inundated with requests from runners seeking alternatives to the outdated advice of RICE and frozen water bottles. While there’s nothing wrong with managing symptoms, runners often stay in pain as a result.
The fact is, foot pain has become a growing issue among runners coming to see us.
Statistics reveal that up to 75% of runners will suffer an injury, annually(1), and plantar fasciitis ranks among the top 5.
Having battled plantar fasciitis myself before I became a physio, I understand the frustration: the morning bottom-of-foot stiffness, the post-run aggravation, the limping, and the persistent heel and midfoot pain. Sound familiar?
Common treatments often focus on ankle/foot mechanics and proper footwear. While these are important, they often overlook the real culprit: the problem often stems from elsewhere in the body.
In a nutshell, our most successful runner outcomes involve the following:
The Overlooked Causes:
In my 25 years of experience working with runners, I've learned that plantar fasciitis is often a symptom of broader issues that include:
- misalignments or compensations in the ribcage, pelvis, or hips particularly in running form.
- Hormonal factors over the age of 30
- Injury to the opposite side, leading to running compensations on the injured side.
- Inadequate warm-up
- Poor running technique and drill work
- Running volume (especially with faulty running form)
- Poor everyday footwear (narrow toe box, high heels, eg)
- Misdiagnosis (for example, heel spurs, insertional Achilles tendinopathy, and tibialis posterior tendinopathy often get misdiagnosed as plantar fasciitis).
- Postural tendencies during everyday activities.
As you can see, there’s more than meets the eye with plantar fasciitis or any condition for that matter.
This understanding has reshaped our Return-to-Run approach over the years. We now dial in on posture, checking on nutrition, recovery habits, ribcage/pelvic alignment, and indoor AND outdoor running gait mechanics to uncover the possible physiological and biomechanical root causes of plantar fasciitis.
We also focus on accelerating recovery using a state-of-the-art regenerative physio modality program for our runners and life-long athletes.
A note on posture- many runners have a relative forward lean posture when they’re NOT running, which places undue tension on the calves and plantar fascia throughout the day.
Notice where the body is in relation to the vertical green line to get a sense of the relative forward lean (our client in the image also has a “swayback”).
Case Study Highlight:
Consider the case of one of our ultrarunners who struggled with plantar fasciitis for years, despite trying everything from rest to traditional PT to dry needling.
A detailed assessment of his running mechanics revealed some key insights:
- his foot pain was linked to hip and pelvis misalignment (see picture)
- narrow running base- “tightrope” running
- Overstriding
- Right foot and hip collapse more on the right than the left side.
- Arm swing (arms far away from body)
Our solution was our Move.Excel.Inspire. (MEI) Method, a 3 step comprehensive approach to getting people back to what they love:
Phase 1: “Retrain the Brain to Accelerate Out of Pain”
- Cutting edge, regenerative physio modalities to accelerate healing:
- Biofeedback running technique drills
Phase 2: “Load and Expose” Rehab
- A run-specific strength program
- Dynamic running technique drills
Phase 3: “Test Retest” and Return-to-Running (“RTR”)
- A tailored return-to-running pain-free protocol
The outcome? He completed his first 60-mile race pain-free last month and has been running better than ever.
Why Traditional PT Fails Runners:
Many patients share stories of traditional physical therapy's limited scope—relying on hot packs, cold packs, and generic exercises, which fail to address the root causes of plantar fasciitis. Even treatments like dry needling provide only temporary relief without tackling the underlying issues.
Key Insights for Lasting Relief:
- Identifying and treating the root causes is essential for lasting recovery.
- Customized, progressive strength and mobility programs and thorough running gait assessments (indoor AND outdoor) are critical, especially outdoor evaluations, which are often neglected.
- Ruling out all other diagnoses and collaborating with coaches on programming is critical for long lasting success on the journey
In summary, for runners struggling with plantar fasciitis, it's time to look beyond conventional treatments. Physio has changed and there are many cutting edge tools out there to accelerate your recovery. Make sure to find a physio who specializes in runners and will provide a whole person approach to helping you get back on the road.
If you’re tired of dealing with that stubborn plantar fasciitis, click here to schedule your completely-free plantar fascia physio assessment today.
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Dr. Jerry Yoo is the Founder of Next Level Physio.
He has worked with elite and professional athletes and runners and triathletes for over 25 years. He is a clinical running research partner with Rutgers University. Dr. Jerry is an expert at helping athletic men and women over 30 get back to what they love to do.
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