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Feeling a stabbing pain near your heel when you step out of bed in the morning or when you get up from your desk? You might have developed plantar fasciitis, one of the most common foot injuries facing athletes today. “It’s the complaint that brings patients to a podiatrist’s office the most often,” says Megan Leahy, D.P.M., podiatrist at the Illinois Bone & Joint Institute in Chicago.
In fact, about one in 10 people will develop plantar fasciitis during their lifetime.
Plantar fasciitis is an inflammation of the plantar fascia, the ligament that runs along the bottom of the foot. Normally this tissue absorbs shock and supports the arch of the foot, but if it is overstretched or strained, small tears in the tissue can lead to inflammation, causing pain and discomfort—especially where the fascia meets the heel bone or at the arch on the bottom of the foot. Most of the time, plantar fasciitis won’t affect you during exercise—you likely won’t feel it until you get home from the gym and are walking around your house or when you get out of bed first thing in the a.m. And the more you walk around on it, the better it starts to feel.
Both athletes and sedentary individuals can develop plantar fasciitis, notes Leahy, since it can be brought on by weight gain, a sudden increase in intensity of activity, or even wearing wornout shoes. Runners are among those who suffer the most often, especially if they are suddenly adding more weekly mileage to their routine. But even frequent HIIT workouts can be to blame, since the pounding of some high-intensity exercises creates more stress through the foot. Other activities that place stress on heels can also create problems, adds Leahy.
But it’s not just your workouts that can cause trouble. Consider your footwear choices: “Constantly squeezing into narrow shoes can prevent the front part of the foot from moving,” explains biomechanist Katy Bowman, author of Whole Body Barefoot: Transitioning Well to Minimal Footwear. That means the smaller muscles of your feet, which should be helping to support the arch as well as dealing with the changing terrain as you walk, are weak, which in turn can stress the plantar fascia. Your toes may also be clenching as you walk, which can further stress the bottom of your feet.
Treatment options for plantar fasciitis vary depending on the severity of the injury. For mild to moderate cases, stretching, rest, and modifying your activities, along with using anti-inflammatories such as ibuprofen, may provide help to alleviate the pain. It can also help to apply ice or cold therapy to the affected area. Some patients swear by a technique called ice massage: Simply freeze a water-filled paper cup and roll it along the bottom of your foot for about five minutes at a time.
More severe cases may need a supportive boot, cortisone injections, physical therapy, or surgery.
“It’s important to see a doctor soon after the onset of pain so the injury doesn’t become a chronic issue,” says Leahy. Left untreated, plantar fasciitis can linger for years, creating a partial tearing or even a full rupture of the fascia.
In addition to reducing inflammation, it’s also crucial to address the underlying reason for the injury. Bowman advises strengthening the small, intrinsic muscles of the feet, which can help reduce the load placed on the plantar fascia.
Mindful barefoot practice at home and doing moves like lifting your toes one at a time can reduce weakness in these small muscles.
Other devices, such as inserts or orthotics, can help modify biomechanical issues, such as rolling your foot in when you walk, notes Leahy. Talk to your doctor to find out whether you might need additional support or physical therapy to address any imbalances that may have contributed to the development of the injury in the first place, she adds.