The most common cause of foot pain in runners is called plantar fasciitis. Plantar refers to the foot, specifically the bottom of the foot. Fascia refers to a layer of connective tissue that is located on the bottom of the foot. “Itis” refers to inflammation. Therefore the most common cause of discomfort in the foot is inflammation of the plantar fascia. There are several issues which may contribute to the development of plantar fasciitis. The purpose of this article is to give you a better understanding of the mechanics of the foot, and to provide you with some basic maneuvers to help you rehabilitate yourself.
The foot is an incredibly complex structure. It is composed of 28 bones, 33 joints, and a myriad of small muscles and bands of connective tissue. In order for the foot to function properly all of these joints must be in alignment, and the surrounding muscles must be active and providing stability. When all of the joints and muscles of the foot are working properly, they maintain the arches of the foot. There are three arches in the human foot. These arches are essential for many reasons, but the one we will focus on is that of shock absorption. Think of the arches in your foot as serving the same purpose as the shock absorbers in your vehicle. If these arches are not maintained, the stress of every impact in your stride is transferred instead to the connective tissue, bones, muscles and joints of the foot, the ankle, knee, hip, and the low back. In individuals with “fallen” or “low” arches, the cause of dysfunction is typically inactivity in the small muscles or “core” of the foot. When the arch is flat, no shock is able to be absorbed. This places undue stress on the connective tissue of the foot, and will predispose you to chronic inflammation and irritation of the plantar fascia. On the opposite end of the equation people with high arches can also suffer from plantar fasciitis. High arches are essentially too rigid. This rigidity is most often due to fixation (lack of motion) of the joints of the foot, and too much tension in the muscles of the calf. Overactivity of the calf muscles tightens the plantar fascia, restricts the motion of the joints of the foot and will predispose the individual to developing inflammation and ultimately pain.
What Can You Do About It?
The most important thing to do when dealing with foot pain is to give your body time to rest. Taking a few days to a week off is a must. If you continue running, inflammation will continue to build up in that area. Chronic inflammation will not only cause pain, but it will also stop the healing process in its tracks. Icing the affected area is the next step to take in the process of rehabilitation. Ice helps to push inflammation out of the tissue and will greatly increase the rate at which you can recover from an injury. Apply the ice for 10-15 minutes at a time. Be sure to leave an equivalent interval of time with the ice off of the affected area before reapplication. Ideally this process should be repeated 2-3 times. The more frequently you apply ice to your injury throughout the day, the more effectively the body can remove inflammation.
If the aforementioned methods have not eliminated your pain, it is time to get both your foot and gait analyzed. Running stores such as Potomac River Running offer a free gait analysis before they make their footwear recommendations. Finding the right type of shoe for your own body mechanics is an essential part of reducing the stress and impact on your feet.
Individuals with high arches should seek to mobilize the joints of the foot. Use a tennis ball to roll out the three arches of the foot before and after a run. Stretch the calf muscles regularly to reduce the tension that they place on the plantar fascia. The goal of your rehab should be to bring flexibility and mobility back to the joints of the foot.
For those individuals that have low arches or "flat" feet; roll your foot on a frozen water bottle before and after a run. The goal of your rehab should be to strengthening the intrinsic or “core” muscles of the foot to help maintain the arches. Consider purchasing a more supportive shoe and or orthotic to use when running, as this will reduce the likelihood of reinjury.
If you find that you are still experiencing episodes of foot pain even after applying the techniques talked about in this article, this may be an indication that the alignment of the joints of the foot are contributing to the chronicity of your issues, and you should seek out a physician who specializes in addressing joint alignment and mechanics. Please message me with any questions that you may have