Heel pain sounds so mundane—until it’s actually your foot that’s under attack. Then suddenly, and excruciatingly, you get it. Holy cow, that bastard hurts. Plantar fasciitis, usually experienced as a dull stabbing in and around the heel, is an insidious bugger that appears seemingly out of nowhere and can be stubbornly resistant to treatment. It can strike any of us, at any time, but it is particularly fond of torturing runners.
The first thing you should know about PF: It never just “pops up,” despite the way it may feel. You just don’t feel it until it crosses your pain tolerance threshold, which is often relatively high if you are a runner, or a father (the only thing more painful than slogging through sub-freezing miles is doubling over after your ticklish toddler kicks you in the groin). Still, you are neither the first nor will you be the last runner to endure heel pain, and the vast majority of men recover just fine with a little bit of patience and rehab.
The key, as with most types of exercise-related injuries, is discipline and consistency. Little things like icing and stretching don’t sound like much of a game plan, but they truly are your best weapons in defeating PF, as long as you employ them multiple times a day, every day, until the pain is gone (more below).
Here’s your guide to ending plantar fasciitis pain for good.
What Is Plantar Fascitis?
Plantar fasciitis is caused by microtears in the connective tissue at the bottom of your foot, which leads to painful inflammation. Spanning from your toes back to the tendon attachments at your heel, this tissue is designed to expand and contract with every step you take. Sometimes, taking a few too many steps can make tear the tissue; other times, a tight Achilles tendon, an unstable landing while running, rapid weight gain, or a job that requires a lot of standing can cause these microtears and that painful inflammation.
Why It’s Hard to Cure
Your body heals itself while you are at rest. During sleep, it gets to work trying to “knit” back together the tears in your foot tissue that occurred during the day. But because your foot is naturally relaxed while you are sleeping, the repairs are done on tissue that isn’t stretched out the way it would be if your foot was flexed. Fast-forward to the morning: When you step out of bed your foot flexes, the plantar tissue stretches abruptly…ouch.
The Fix-It Plan, Part One
Your first stop is an over-the-counter non-steroidal anti-inflammatory like ibuprofen. Next step: ice it. The easiest way is to pour tap water into a bunch of paper cups, then put those in the freezer. Three times a day (morning, night, and after your run), grab a frozen cup, peel back the paper edge to expose the ice, then hold it like an ice cream cone as you make circles around your heel region, gently applying pressure as you go.
Every morning (yes, every single morning) when you get out of bed, immediately turn to face a wall and very gently stretch your Achilles tendon with a calf stretch. This is NOT your major post-run, work-out-the-cramps stretch. This is a soft, shallow stretch to gently loosen your calf area. Tight calves are a primary culprit of PF, as the stress from limited calf flexibility causes greater tension on tendon attachment at the heel.
Fix It, Part Two
To take the strain off your foot, wear sneakers everywhere: on your commute, while pushing the stroller, during your trip to Costco. PF is aggravated by not have enough arch support and foot stability; cushioned shoes will help.
You can also help your cause during the night hours by purchasing what’s known as a Strassburg sock. The secret weapon of runners everywhere, this is basically a knee sock with a sturdy, adjustable band that runs from the toes to the knee. It holds your foot in a flexed position as you sleep, meaning that those little torn fascia fibers are repaired while the arch is stretched, so they won’t re-tear with your first step in the morning.
If none of these strategies seem to help, see a sports medicine doctor and ask about a corticosteroid injection. The good news: The shot can provide almost instant pain relief. The bad news: It doesn’t last, and the treatment is used sparingly as it weakens the tissue and can ultimately contribute to the plantar fascia rupturing entirely. A sports medicine doc might also give you some at-home exercises to try and strengthen your foot, ankle, and calf area. In some cases, orthotics or shoe inserts can help provide better arch support, alleviating some of the pain. It may take time, but you’ll be back on your feet chasing your kids again soon.