Understanding plantar fasciitis and why runners hate it so much


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When I found out that I had plantar fasciitis, I thought my time as a runner was over. But thanks to some much-needed rest and the advice of my podiatrist, I am still running and learning to cope with this affliction. Here, Dr. Charles R. Oehrlein, a podiatrist with The Hoover Foot Center in Alabama, tells us more.

In layman’s terms, what is plantar fasciitis?  
Plantar fasciitis is inflammation of the plantar fascia [a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes]. This inflammation typically occurs at the origin of the fascia on the bottom of the foot at the calcaneus. There is usually an exact area you can press on that will cause severe pain. The pain is also most noticeable when first getting up in the morning or after sitting and resting. When you have “PF,” you are causing the fascia to stretch, but it is not designed to stretch, so it rips and tears, which causes the pain.

How can plantar affect someone’s ability to walk or run?  
The simple answer is the pain causes the problems. It is hard to walk, let alone run, when your foot is hurting with every step you take.

What are some home remedies that you would suggest? For example, you advised me to roll my foot on a tennis ball after running, or a frozen water bottle, and spell the alphabet with my foot before getting out of bed in the morning.  
Those are all great. Remember, we’re dealing with inflammation, so anything that will help inflammation [is good]. The stretching exercises you mention are great [because] if you can get the fascia stretched out a bit, you reduce the amount of ripping and tearing that occurs. Also, heel cushions are useful to help reduce the impact on the heel.

What are some treatments that a podiatrist can prescribe to help with this condition?  
When home remedies no longer work, then it is time to see your podiatrist. Typically, I use an injection of steroid, strapping [and an] oral steroid on the first visit, which greatly reduces the inflammation and pain, as well as controlling motion of the foot. The second visit, if the strapping is well tolerated, I will usually use our digital scanner to capture the foot and use that to make a custom fabricated orthotic (which is very, very different from the orthotics you get at [a store]) and dispense a night splint to help with the stretching we mentioned above. Once the orthotics are dispensed, we may write [a prescription] for a topical medication that allows for relief if the fasciitis flares up. However, some patients find no relief with all conservative methods and thus will require surgery.