February 10, 2017



I have found that there are two types of plantar fasciitis that affect runners and other people. What I would call the regular type and the chronic type. What's the difference you ask? With regular plantar fasciitis, there is the acute inflammation caused by the micro-tears that with rest, compression therapy, ibuprofen, and such, can subside within a week. However, there are many runners that also develop chronic plantar fasciitis that can last several months and even be resistant to normal treatments. One study has done by scientist that biopsied the plantar fascia tissue of chronic plantar fasciitis sufferers. What they found was fascinating. In the biopsies, they found little to no inflammation. If this is the case, then obvious treatments like icing, ibuprofen, or even cortisone shots, which is a powerful pain reliever but also anti-inflammatory are not the right course of action. Of course, the pain relief that comes with the shot is greatly welcomed, but maybe it is time to re-examine treatment for chronic plantar fasciitis. Today it is more commonly believed that chronic plantar fasciitis is caused by both the weakening and degeneration of the plantar fascia, and not acute inflammation. In runners, for instance, the pounding of the pavement causes micro-tears. We often think that our bodies, which because they are capable, repair and actually strengthen the tissues during the times of rest and recovery between runs. Like in lifting weights, that recovery would seem to make the “repaired you” stronger and more capable of sustaining even higher levels of training. But what if, with chronic plantar fasciitis, the tissues don't actually repair themselves but overwhelm the body's ability to respond? Then instead of repaired tissues, there are accumulated torn tissues. The plantar fascia tissues begin to degenerate and tear worse. Here's another question. Then what is the best treatment for chronic plantar fasciitis? While stretching exercises can relieve some of the pain, as well as icing and ibuprofen, one cannot count on that to actually start the healing process. So there are two things that I recommend. If the muscles are being weakened, doesn't it make sense to strengthen the muscle? But Drew I thought you just said, stretching won't help? I said it might provide pain relief, but if a lack of flexibility is not a root cause, then this might not help repair the tissue. In order for the tissue to repair, the surrounding muscles must be strengthened along with the plantar fascia. How do we do this? We exercise and strengthen our calf muscles and plantar fascia. Last week I mentioned doing about 100 calf raises a day. This is a good start in helping strength the supporting muscles that tie into the heel. Since the plantar fascia is connected to the heel as well, we definitely want to work on strengthening both. One commonly forgotten exercise for the plantar fascia is simply the “Toe Grasp”. While standing with feet about hips apart, take turns alternating each foot with the grasping motion of trying to pick something off the ground. You can even add a step in there as you walk and do this motion. The goal would be to work up to about 50-60 a day with each foot. Doing this daily can help to strengthen these muscles, as well as, prevent future occurrence. The second thing I would mention is compression therapy, like wearing a great pair of plantar fasciitis socks (Graduated Compression Socks). These socks act as a way of supplying extra oxygen and blood to the plantar fascia through compression. This extra oxygen can help speed up the healing process. As I have mentioned with these socks before, all feet are different. If one brand doesn't work for you, please try another that might. All might be slightly different, but once you find the brand that works, you will know it. As always, stay healthy so you can stay fit. Cheers, Drew

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