Plantar Fasciitis for runners can be extremely painful, in some cases, leaving you unable to walk. In severe cases, it can lead to months of pain and time off from running.
If you’re worried that you may have developed the infamous plantar fasciitis, don’t worry.
Incidence rates of plantar fasciitis for runners range anywhere between 4.5% and 10%, making it one of the most common injuries for runners to experience.
It can be treated, and you can run again!
So, plantar fasciitis so bad I can’t walk? Never fear! Today we’ll take a look at a blueprint of rehabilitation, from not being able to walk without pain to getting back out there on the trails.
In this article, we will cover:
- What Is Plantar Fasciitis?
- How To Effectively Treat Plantar Fasciitis
- Plantar Fasciitis So Bad I Can’t Walk: Exercises
- Plantar Fasciitis So Bad I Can’t Walk: Summary
Let’s jump, softly, into it!
What is plantar Fasciitis?
The plantar fascia is a vital structure composed of three fibrous bands of connective tissue that insert into the heel bone (calcaneus).
It extends forward, creating a strong mechanical linkage between the heel and the toes, resembling both a tendon and a ligament. This structure contributes to the foot’s spring-like function.
A common musculoskeletal disorder related to the plantar fascia is plantar fasciitis, which primarily affects the fascial enthesis—the point where a tendon or ligament attaches to a bone.
Contrary to its name, plantar fasciitis is not primarily an inflammatory condition but rather a fasciopathy.Causes:
The precise cause of plantar fasciitis remains unknown, although it frequently occurs in runners who rapidly increase their mileage or are new to running.
The relationship between cause and effect in this condition is complex and not fully understood.
Plantar fasciitis is often characterized by the thickening or degeneration of collagen fibers in the plantar fascia.
It has long been assumed that excessive tensile loading at the calcaneal enthesis contributes to the development of plantar fasciitis.
Symptoms:
Symptoms of plantar fasciitis can vary among individuals.
Most runners with this condition experience heel pain when pressure is applied to the foot, which can manifest as a dull, burning, or stabbing sensation.
The pain is typically concentrated around the calcaneus, but it can also radiate from the heel toward the toes.
Heel pain when you first wake up is common, improving as the foot muscles warm up, and pain can intensify after periods of sitting.
How to effectively treat plantar fasciitis
We have all heard of well-known principles such as RICE, but in reality, there is so much more complexity to the managing and rehabilitation of soft tissue injuries.
Today we will take you through the PEACE & LOVE protocol, discussing how it can help with plantar fasciitis.
RICE takes advantage of cold-induced analgesia and the assurance and support provided by compression and elevation, yet generally only focuses on the acute stage of healing.
The format below represents a blueprint that I use in the clinic when working with a client with plantar fasciitis.
That said, this article is not designed to replace medical advice. If you have an injury, we recommend seeing a qualified health professional. They will be able to provide you with the best treatment for you.
PEACE
Immediately after injury, do no harm and let PEACE guide your approach.
Blaise Dubois
P for Protect:
- During the first few days, you should unload the plantar fascia and limit movement. This will help prevent further aggravation and distension of the injured muscle fibers.
- Although initial rest is often crucial, complete rest should be minimized as it risks compromising tissue strength and quality.
- Pain is a messenger; as the intensity of pain becomes to become more manageable, you can start to remove layers of protection and begin to move the muscle gradually.
E for Elevate
- Elevate the injured limb higher than the heart. This should help promote interstitial fluid flow, aiding in the recovery process. Despite the lack of quality evidence advising efficacy for elevating the foot, there is a low risk-benefit ratio.
A for Avoid Anti-Inflammatory Modalities
- Anti-inflammatory medications may negatively affect long-term tissue healing. Although inflammation has historically been thought to interfere with skeletal muscle regeneration, recent studies have started to highlight the beneficial effects of inflammatory cells on muscle healing.
- Avoid using ice. The use of ice is largely analgesic, and although it is widely used, there is very little high-quality evidence that supports it. In fact, it may potentially disrupt inflammation, delaying the healing process.
C for Compress:
- Similar to elevation, there is little high-quality evidence to support the use of compression when treating plantar fasciitis. However, there is evidence to show that it increases confidence in using the muscle.
E for Educate:
- Plantar Fasciitis can be a daunting injury. Consistent and dull pain can feel like it will last forever. The more we are educated on an injury, the less daunting it is.
- We should adopt an active approach to recovery instead of a passive approach. Although passive therapies, such as electrotherapy and acupuncture, can play a part, their long-term efficacy is low when compared to an active approach to rehab.
- We should look to nurture the body’s natural ability to heal, strengthening the muscle fibers gradually over time.
- We should set realistic expectations about recovery times. For plantar fasciitis, that can range anywhere between 3-9 months, sometimes longer. There is a large degree of leeway, dependent on participation in rehabilitation.
LOVE
“After the first days have passed, soft tissues need LOVE”
Blaise Dubois
L for Load:
- We should introduce activities as soon as symptoms allow for it. This will promote repair and remodeling, building tissue tolerance and capacity.
- Optimal loading is different for each individual and will change throughout the course of rehabilitation. What is difficult at the start will be easy by the end, and vice versa.
- Minimal pain is to be expected when loading the plantar fascia, although excessive pain is to be avoided.
O for Optimism:
- Adopting a biopsychosocial model of rehabilitation can help us take the full picture into account.
- The brain plays a significant part in rehabilitation; when in the midst of a painful injury, it is easy to catastrophize, get scared, and depressed.
- Pessimistic patient expectations can influence the outcomes of plantar fasciitis. That’s not to say we need to be overly optimistic or that we can’t ever feel pessimistic. But maintaining a healthy level of optimism that this will end, and it will end, will aid in rehabilitation.
V for Vascularisation:
- Plantar fasciitis injury management should include cardiovascular activity. Pain-free cardiovascular activity is not only a motivation booster, but it will increase blood flow to injured structures.
E for Exercise:
- The use of exercise therapy in the treatment of plantar fasciitis will help restore mobility, strength, and proprioception.
- Follow the principle of progressive overload. Progressive overload is the gradual increase of load/stress on the musculoskeletal system.
- Avoid excessive pain to promote optimal repair in the subacute phase. Using it as a guide to progress the difficulty of the prescribed exercises.
Plantar Fasciitis So Bad I Can’t Walk: Exercises
#1: Gastrocnemius Stretch
A recommended stretch for individuals with plantar fasciitis. This particular stretch targets the gastrocnemius muscle and is straightforward to perform, requiring only a wall for support.
- To begin, stand facing the wall with your hands placed on it, ensuring that your back leg is straight.
- Both feet should be firmly planted on the ground, aligned with the wall. Keep your front leg slightly bent.
- As you gradually lean forward, pressing against the wall, you will experience a stretching sensation in the calf muscle of your back leg.
- Maintain this position for approximately 30 seconds, allowing the stretch to be effective, before releasing and relaxing your muscles.
3 sets, 30-second hold
#2: Tennis Ball Roll
For this exercise, get a tennis ball or golf ball.
- Whilst standing, place the ball under your affected foot.
- Apply light pressure onto the ball and begin rolling the ball back and forth under the arch of your foot.
3 minutes of rolling twice per day
#3: Toe Curls with a Towel
- To perform this exercise, you will need a small towel and the option to either stand or sit in a chair.
- Start by placing the towel on the floor. Position your foot on top of the towel, whether you are standing or sitting.
- Using the toes of your affected foot, scrunch or curl them to grip the towel and attempt to pull it towards you. Maintain this contraction for a duration of 2 seconds.
- After the 2-second hold, release the tension in your toes and let the towel go.
3 Sets, 10-15 repetitions
#4: Heel-Raise
- Find a step or elevated platform and place a towel under your toes. Ensure your toes are flexed upwards, pointing towards the ceiling.
- Begin the exercise by rising up on your toes, initiating a three-second upward movement known as the concentric phase.
- Hold the raised position for two seconds, maintaining a static contraction. This is called the isometric phase.
- Lower your heels slowly and control the descent over a three-second period. This downward movement is referred to as the eccentric phase.
For progression, you can advance from using both feet on the step to performing the exercise with only one foot on the step. This variation increases the challenge and further engages the muscles involved.
3 Sets, 10-12 repetitions
Plantar Fasciitis so bad i cant walk: summary
If you find yourself with plantar fasciitis, a structured program of rehabilitation, guided by a trained professional is a must. You will give yourself the best chance of a speedy recovery alongside preventing any re-occurence.
If you would like to know more about plantar fasciitis, check out: Running With Plantar Fasciitis: What Is It + 7 Exercises To Recover Quickly
