In the previous edition of this series, we introduced the concept of overuse injuries. We discussed what Plantar Fasciitis is and how to recognize the condition based on its signs and symptoms.
But what if you already have an overuse injury?
What the heck do you do now?
Well luckily for you we’ve got the answer to your problem. In this article we will be discussing the following topics:
Now before we get going, I think a short recap of plantar fasciitis (PF) is necessary.
Plantar Fasciitis is an inflammatory overuse injury that is characterized by the thickening of the fascia located on the arch of your foot. Symptoms of PF include tenderness, a sharp piercing or stabbing pain and swelling around the base of the foot.
PF can be caused by a few different risk factors such as being overweight, improper footwear and over-training. For a more detailed breakdown of PF you can head over to the previous article in this series.
1. How to Test for Plantar Fasciitis
Even though PF is technically an orthopaedic condition, there isn’t a 100% proven method to test for it. If you do suspect you might be suffering from PF the best option is to contact your primary care physician or your family doctor. He or she will do a physical exam and in some cases extra scans such as an x-ray or an MRI would be required to determine the extent of the condition.
2. How to Treat Plantar Fasciitis
When it comes to treating overuse injuries the prognosis is usually to stop your activity for a while and progressively return to training. However, we suggest a more structured approach to treating PF. This approach consists of 3 phases:
Phase 1 would be to treat the symptoms. For this stage the RICE protocol is usually the way to go, and we recommend starting this method of treatment immediately after the onset of your injury up and until a week thereafter.
Let’s get into this a bit more, RICE is an acronym for:
3. Plantar Fasciitis Rehabilitation
You’ve identified that you do indeed suffer from an acute case of PF. You’ve done the research and followed your doctor’s orders and followed a thorough RICE protocol. It’s been a few days of no training and you’re showing little to no symptoms whatsoever.
You decide to go for a quick run around the neighborhood. I mean what could it hurt, right?
Unfortunately, within 2 minutes of being on the road your symptoms start to flare up and you decide to stop and walk back home. Back to square one and all your “diligent” efforts to treat your PF was all for nothing.
Don’t be this person.
Remember PF is just like any injury, something is broken and it needs to be fixed. The initial treatment protocol is only one step of the healing process. The RICE protocol serves to get you pain free as soon as possible. But that’s only half the battle.
In order to rehabilitate or “fix” your injury you will need to follow a return to play or in this case a return to run protocol. This is a series of steps aimed at restoring your body, or in this case, your foot's normal function.
Okay, so Phase 1 (RICE protocol) is done and dusted.
On to Phase 2, during this stage you would be focusing on mobilization and strengthening your plantar fascia. To simplify this as best as possible, you will be focusing on stretching and reintroducing load bearing to the affected area.
Doing a series of daily calf and soleus stretches is the best and most effective method to mobilize the plantar fascia.
Now in terms of strengthening, we don’t mean hitting the gym. But what we do recommend is to strengthen the affected joint, which in this case is the ankle and foot joints. By doing a series of lower limb exercises, you will be reinforcing an area of your body that once lacked stability and to a certain extent durability.
Both the stretching and strengthening exercises should be done a minimum of 3 times per week to ensure your plantar fascia receives adequate stimulation in order to recover as soon as possible.
And finally Phase 3: return to running. During this phase your aim is simple. Mimic the stresses you will experience when doing your preferred activity or sport. So you will essentially be running, but with a bit of a twist.
Instead of putting on your trainers and hitting the road for 25 minutes, you will rather be introducing controlled bouts of running. So for example you would do a 5-10 minute run every day for the first 3 days. On the fourth day you would do two separate 10 minute runs per day for 5 days. Rest a few days, and then start off with 10-15 minutes runs daily for 3 days. And repeat. You get the idea.
Now this is purely an example of how to implement phase 3. There are loads of ways you can do this so by all means get creative. As long as you retrain yourself in the exact same way as you would compete then you should be good to go!
Conclusion
To conclude, when trying to treat plantar fasciitis there are 3 phases you should follow.
Phase 1 is to implement the RICE protocol asap.
Phase 2 focuses on mobilizing and strengthening the affected area.
And finally phase 3 is your return to play (run) stage. Here you will proceed to use limited and controlled bouts of similar activities, as a method to gradually reintroduce your body to the activity you plan on returning to.