Defeat your “Arch” enemy

You wake up in the morning, roll out of bed to get in the shower and when you take that first step you get a severe shooting pain in your foot. It feel as if someone is stabbing a knife into the bottom of your foot. After you shower it seems to loosen little and by the time you get to work, your foot is sore but the pain is manageable. Most of the time you are still able to run and do your activity, although the soreness never completely subsides.

So what is the problem? More than likely you are suffering from plantar fasciitis. Although seen with all sports and activities, it is probably most common in runners. The plantar fascia is a thick fibrous band that runs along the bottom of your foot. It is made primarily of connective tissue and thus can be difficult to stretch because it is inelastic. During the course of activity it can become inflamed causing pain, usually localized near the heel, but can cause pain all along the foot. You may feel a “crunching” feeling if you rub the bottom of the foot.

So why is it worse in the morning and improve during the day? When you sleep at night your foot relaxes in a plantar flexed position, or toes pointing down. This shortens the fascia and causes a contraction of the area. When you wake up in the morning and step down, you are then elongating an inflamed tendon that has been in a shortened state for several hours. This causes that severe and sharp shooting pain. As you move during the day, you essentially “stretch” the area, thus it begins to feel better.

So what can I do? First and foremost is to take some time off from the activity that is causing the problem. Cross train on a bike or swim at least every other day if you can’t stop completely. Stretching your calf muscles is crucial. Stretching both the gastrocnemius and soleus requires you to stretch two different ways. You must stretch with your knee in a straightened position to stretch the gastrocnemius and bent to stretch the soleus. Hold these stretches for 45-60 seconds each and repeat several times throughout the day.

Another good idea is to massage your foot. This can be done several ways, but the most effective way is to use a baseball to roll under your foot. This will help with stretching the area and also provide a deep massage. If you feel adventurous, then use a golf ball which will give a more localized approach. After activity, it is beneficial to use an ice cup on the bottom of your foot. You can also freeze a water bottle and then roll your foot on it after activity.

If none of this helps you may need to see a physician. They may prescribe some NSAID’s and place you in a night splint. This apparatus keeps your foot in a dorsiflexed position during the night. This keeps the tendon stretched so when you get up in the morning, it won’t feel like you are ripping the fascia. They will also strongly encourage to rest and cross train. Again, take care of the problem early before it becomes a issue.

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