The most common cause of foot pain in runners is from a condition called plantar fasciitis. It can be a severe sharp pain in the sole of the foot just off the heel bone. It is a chronic degenerative condition of the connective tissue in the foot (the fascia) that is brought about by excess training load. It is also associated with biomechanical abnormalities such as flat feet and tight calves.
If you are suffering from plantar fasciitis your foot can be quite stiff and sore first thing in the morning and get painful when you walk or run. Your foot can get so sore that you have to stop running altogether.
The plantar fascia is a piece of connective tissue that comes off the heel bone and runs up the sole of the foot into the toes. It adds structure and support to the arch of the foot and allows force to be transmitted from the calf, through the foot into the toes.
It is thought that the condition develops much like a tendinopathy. First there is excessive loading (being over-weight or running a lot), this leads to mal adaption in the fascia, with degeneration and breakdown in the collagen at the base on the heel. There can also be small tears in the fascia and the development of bony heel spurs the more chronic the condition becomes.
There are a number of treatment options available for plantar fasciitis. The most current first line of treatment for plantar fasciitis is shockwave therapy. We provide shockwave therapy at Wandsworth Physiotherapy and Osteopathy. A course of 3-6 sessions is recommended. Shockwave should be accompanied with deep soft tissue work into the calf muscle and plantar fasciitis itself and stretching of the plantar fasciitis and calf muscle that can be done at home. You can also do some self-myofascial release work of the plantar fascia at home with a tennis ball or golf ball. As with other tendinopathies the next thing that needs to be done is to strengthen the calf and planter fascia, this is best achieved by doing isometric strengthening exercises to begin with.
It’s not unusual to take six sessions of shockwave and two or three months of physiotherapy, and home stretching and strengthening exercises to see any change in your symptoms. You can also try taping techniques that can offload the irritated plantar fascia or but a silicone gel heel pad that you can wear in your shoes to cushion the painful area. If after a prolonged period of treatment you are still suffering from here pain there are a couple of options available to you.
The first one you could do is to sleep with a Strasberg sock this is a special sock that pulls the foot and toes towards the shin, stretching the calf and plantar fascia overnight. You could also be referred to a consultant orthopaedic foot and ankle surgeon for a steroid injection.