Plantar fasciitis is a common injury experienced by runners that results in heel pain, which can range from mild to debilitating depending on the severity of the injury.
The plantar fascia is a ligament that begins at your heel as thick bundle of fibers and gradually fans out and attaches to your toes. Anytime you're on your feet, the plantar fascia comes into action to stabilize and support your foot so it can maintain its shape. This could be something as simple as walking up or something as dynamic as landing from a jump.
Overtime, too much stress on the plantar fascia can cause the ligament to break down, resulting in plantar fasciitis and the associated heel pain. Runners are particularly susceptible to this injury because of the repetitive stress and overuse from logging several miles every week, however anyone that's regularly on their feet is at risk.
According to Dr. Matt Stevens, physical therapist and owner of Pure Physio (Strongsville, Ohio), plantar fasciitis is oftentimes caused by a mobility problem with your ankle or big toe—yes, big toe mobility actually matter.
"When we are running and walking as we are moving forward, we need the knee to be able to track and as the heel lifts we're getting bending in the big toe. So we're getting ankle range of motion and toe range of motion at the same time," explains Stevens. "If we don't, we tend to put a lot of load and extra stress in the plantar fascia in different planes that can eventually cause breakdown and injury."
Oftentimes this injury is treated with rest, ice, anti-inflammatory drugs, supportive shoes and rolling the area with a tennis ball. These strategies may relieve the pain, but they don't address the cause.
To identify the cause of your plantar fasciitis or to identify if you're at risk, take the following two tests.
Wall Ankle Test
How to: Kneel with your right knee on the ground and position your left foot so that your toes are four inches away from a wall. Keeping your front foot on flat on the ground and back straight, push your left knee towards the wall. If your knee can touch the wall without your foot moving, then you have sufficient ankle range of motion.
Big Toe Test
How to: Stand with your feet hip-width apart and slightly bend your right knee so that the front of your knee is over your toes. Have a partner lift your right big toe off the ground as far as possible (it shouldn't be painful). If your toe can lift about 30 degrees off of the ground, then you have sufficient big toe range of motion.
If you fail one or both of these tests, Stevens recommends the Toe-Elevated Ankle Stretch to correct the mobility issue(s) and treat or prevent plantar fasciitis.
How to: Kneel with your left knee on the ground and place your right foot flat on the ground. Roll up a towel so it's an inch or two thick and place it under your right big toe. Keeping your back straight, push your right knee forward until you feel a stretch in your calf and foot (it shouldn't be painful). Hold for the specified duration (stretch routine) or slowly move into and out of the stretch (warm-up).
Sets/Reps: Stretch routine: 4-5x30-45 sec. each leg / Warm-up: 2x20 each leg
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