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Poor form is a common cause of running injuries but an orthotic insert will help to keep you on the right track. This article is intended as a guide. For more advice on dealing with plantar fasciitis or any other running-related injury, visit our injury advice page. This can be achieved by reducing activities that increase pain such as walking barefoot and running. Taping the fascia can also help. Stretching the Achilles is widely recommended for plantar fasciitis but it might be best avoided in the reactive stage as it places greater stress on the fascia.
With more chronic degenerate plantar fasciitis load management is still key but can involve a gradual increase in load on the plantar fascia. Strengthening calf muscles and tibialis posterior may also help these muscles to manage load associated with impact during running to prevent recurrence. Again if we take the lead from tendinopathy management we have some guidance in terms of pain and exercise. Research on achilles tendinopathy by Silbernagel found that people could continue sport as long as they aimed to keep their pain below 5 out of 10 where 0 is no pain and 10 is worst pain you can imagine and pain had reduced by the next morning.
You could certainly apply this concept to plantar fasciitis. Indeed, many runners continue to run with their symptoms. When we consider the stress on a tendon or the plantar fascia with often think of tensile load which places a stretching force on the tissue.
Until fairly recently compression has been overlooked but Cook and Purdam highlight the importance of compressive load. However according to Wearing compressive load has not been fully examined in plantar fasciitis. Perhaps future research will shed light on this. What is the Windlass Mechanism of The Foot? A number of factors will play a part in loading — your training type, volume and intensity will have a role as will footwear and training surface.
There can be a connection between barefoot running and plantar fasciitis as this promotes forefoot striking and increases load on the calf complex. This can help you identify a cause to your plantar fasciitis and potential solutions. Several risk factors have been identified in plantar fasciitis and generally these link to increase load on the fascia;. Addressing these factors will likely reduce load on the plantar fasciitis allowing the tissue to heal.
Stretching the calf muscles has been a cornerstone of plantar fasciitis rehabilitation for years. Many articles in the literature recommend it alongside traditional exercises like rolling your foot over a frozen bottle of water.
Despite its popularity there is a sparsity of quality evidence supporting calf stretches for plantar fasciitis. The theory is that a tight achilles increases load on the fascia so we stretch it to reduce load. The problem is there is some debate whether stretching will actually achieve this.
A big question too is why stretch a condition that is usually aggravated by tensile load? Cole et al. That said I do feel achilles stretches have a role in more chronic cases where you are aiming to gradually increase load on the fascia.
There is some evidence that stretching the plantar fascia itself may be more effective — DiGiovanni et al. Their follow up study DiGiovanni et al.
Many aspects of plantar fasciopathy have not been extensively studied. My thoughts here come from the perspective of a reasoned way of managing a condition heavily linked to overload with many similarities to tendinopathy. However, without a sound evidence base this can only really be theory and opinion in relation to plantar fasciopathy.
Indeed while there are similarities to tendinopathy which has been used as a framework to guide some of these ideas there are differences too. The use of isometric and eccentric exercise has become a key factor in managing tendinopathy, this is difficult to achieve with plantar fascia.
It can be helpful to think of plantar fasciopathy as a response to excess load. This can be an acute response that will settle with temporary reduction in load or a more chronic response that requires a gradual re-introduction to loading. There are similarities with tendinopathy that might help guide us in some respects but this approach is not evidence-based.
In the Cochrane Collaboration did a systematic review of interventions for treating plantar heel pain. The researchers found no statistical difference in 5k time or other markers for performance, such as submaximal oxygen consumption or lactate threshold. In a second study , researchers measured the effects of aqua jogging over a six week period. This time, 16 runners were separated into two groups — one who did aqua jogging workouts and the other who did over land running.
Using the same training intensities and durations, the researchers found no difference between the groups in maximal blood glucose, blood lactate, and body composition.
Research has also demonstrated that aqua jogging can be used as a recovery tool to facilitate the repair of damaged muscles after hard workouts. These findings make aqua jogging an important recovery tool in addition to being the best cross training method for injuries. The calories burned aqua jogging are even higher than running on land, so if you want to avoid weight gain while you take time off from running, this is definitely the exercise for you!
If you're interested in aqua jogging to rehab your injury, then the absolute best way is to use one of my favorite programs, Fluid Running. First, it comes with an aqua jogging belt and waterpoof bluetooth headphones so you have everything you need to aqua jog effectively. Second, they have an app that pairs with the headphones so you can get workouts, guided instructions on how to aqua jog properly, and motivation while you're actually pool running.
This has been an absolute game changer for me when I am injured. I used to dread aqua jogging workouts because they were so boring and it took all my mental energy to stay consistent.
But, with workouts directly in my ear, it's changed the whole experience and I actually look forward to the workouts. So much so that I now use aqua jogging as a cross training activity in the summer, even when I am not injured. Fluid running is an awesome deal when you consider it comes with the belt highly recommended for better form , the waterproof headphones game changer for making pool workouts fun , a tether to add variety to the workouts you can do and the guided workout app to make your cross training structure and a whole lot more interesting.
That's why we've partnered with them to give you 2 additional running-specific workouts you can load into the app when you use the code RTTT. Check out the product here and then on the checkout page, add the code RTTT in the coupon field and the workouts will be added to your order for free.
If you'd rather do the aqua jogging workouts on your own, here are some great ideas to get you started! Finish with 10 minutes easy cool down. One of the difficulties of cross training is replicating those truly lung-busting, difficult workouts. Tie one end of the resistance band to a sturdy object pole, lifeguard stand, pool ladder and bring the other into the water with you. Put the strap around your waist and begin aqua jog away from your starting point. Spend a few moments testing yourself to see how far you can pull the bungee.
This is a great challenge and a fun way to compete with yourself during an otherwise boring cross training activity. Pick a point on the pool wall or side of the pool that you feel stretches the bungee to a very hard sprint that you could maintain for seconds. When you complete the hard workouts, you can use these reference points to ensure that you maintain a very hard effort. Repeat 10 times. Repeat 4 times. Repeat 12 times, 10 minutes easy cool down. You can challenge yourself and make aqua jogging more fun by seeing how long you can stay at your maximum stretched distance or seeing how far you can push it.
Likewise, if you have a friend who is injured or someone willing to be a good sport you can try pulling each other across the pool for some competitive fun. However, I hope that providing a variety of workouts, either through the Fluid Running app which also makes it easier to keep track of the workout while in the water or on your own can add a fun challenge in the pool and you can emerge from your injury with minimal fitness loss.
How quickly you can return to running will depend on the severity of your injury and how fast you heal. Some runners find that they can work their way back into running even while some residual arch stiffness persists, but if running is making your arch pain worse, you need more time off and more time for your rehab program to do its job. Your team of expert coaches and fellow runners dedicated to helping you train smarter, stay healthy and run faster.
We love running and want to spread our expertise and passion to inspire, motivate, and help you achieve your running goals. Taunton, J. British Journal of Sports Medicine , 36, Riddle, D. Journal of bone and Joint Surgery , 85 5 , Kibler, B. American Journal of Sports Medicine , 19 1 , Davis, I. Clinical Journal of Sports Medicine , 19 , Lemont, H. Journal of the American Podiatric Medical Association , 93 3 , Dye, R. Journal of the American Podiatric Medical Association , 97 4 , Cole, C.
American Family Physician , 72 11 , DiGiovanni, B. Journal of Bone and Joint Surgery , A 8 , Barry, L. The Journal of Foot and Ankle Surgery , 41 4 , Ziya Tatli, Y. Current Reviews in Musculoskeletal Medicine , 2 1 , Gudeman, S.
American Journal of Sports Medicine , 25 3 , Rompe, J. American Journal of Sports Medicine , 31 2 , Ogden, J. Clinical Orthopaedics and Related Research , , Moen, M.
British Journal of Sports Medicine , 46 4 , Barrett, S. Podiatry Today , 17 11 , Hamill, J. Human Movement Science , 14 1 , And, based on data from physiotherapists, the most frequent injury running patients report. But, figuring out. Running can be tough in the best of times, but when the pain keeps getting worse until you cannot run another step, well, that is. Trigger point massage on those muscles, often coupled with use of the foam roller or massage stick and a day or two off, can usually eliminate plantar pain quickly if I catch it right away.
Agreed, Adam. PF problems are pretty easy if treated immediately, but once it gets bad — ouch.
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