Plantar Fasciitis- the marathon runners heel pain

Diagnosis of plantar fasciitis is confirmed by pressure applied over a very localised spot under the heel which is made worse after rest. First thing in the morning when rising from bed can be very painful when you put your feet down on the floor.

The painful heel is caused by the elongated medial arch of the foot when the ankle overpronates. Lengthening of the arch puts a stretch on the structure under the foot called the plantar fascia which is pulled away from the heel. This causes an inflammatory response and thus the resulting heel pain will manifest itself.

When the fascia of the foot is warm and in use during exercise it is able to absorb the mechanics of stretching, however when rested the fascia cools down and becomes less pliable and pulls at its insertion on the heel creating discomfort.

In order to treat the problem you need to prevent the overpronation by either fitting prescriptive orthotics or using a temporary non stretch taping which prevents the lengthening of the medial arch of the foot. Electrotherapy should be employed alongside soft tissue manipulation in an attempt to treat the fascia. This can be done by a Sports Physiotherapist or Sports Therapist. Massage can help stretch the plantar fascia but must be done in the direction of the heel to prevent pulling at the painful attachment.

Plantar Fascia stretching may be needed to reduce the stress on the underside of the foot.

As the condition is of an inflammatory nature then icing the area is very important. This condition if left untreated may develop into a heel spur which will take much longer to deal with.

Steroid injections are often prescribed by Gp's and can be successful in pain relief however the pain often returns because the cause of the condition has not been addressed.

Aggravating factors can be excess weight gain which puts more weight through the feet and increase in high impact weight bearing activity such as running. The condition is simple enough to treat for the experienced therapist who can identify the cause of the condition.

Custom orthotics can often be the answer if you pronate or overpronate. The overpronating runner will stretch the plantar fascia and irritate the heel causing heel pain.

Advice would be to obtain a full Biomechanical Evaluation from a Sports Podiatrist who will determine if you may need orthotic supports in your running trainers.