A step-by-step guide for runners recovering from heel pain
Plantar fasciitis is one of the most common foot problems in runners. The plantar fascia -- a thick band of tissue that fans out from the heel to the base of the toes -- develops tiny tears from repeated stress that outpace the body's ability to repair them (the problem is now understood to be more degenerative than inflammatory).
The hallmark symptom is sharp pain with the first step in the morning.
Running through the pain greatly delays recovery, so a gradual return-to-running plan is essential.
Each foot strike puts 2 to 3 times your body weight on the plantar fascia
A sudden increase in mileage or tight calf muscles add extra strain to the fascia
Pain focuses on the inner front part of the heel
The fascia tightens during sleep, and that first step in the morning stretches it suddenly
Most runners are reported to improve within 6 to 18 months. Extracorporeal shockwave therapy has been reported to help reduce pain, but the response varies from person to person (temporary pain, redness, swelling or bruising can occur at the treated area). A patient, step-by-step approach leads to an earlier return in the long run.
Caution during the acute phase
Bamboo foot rollers and golf ball massage are not recommended during the acute phase. Also, pain that worsens after activity -- even if it felt fine during activity -- is a sign that the load on the fascia is too high. Continuing to run through pain can extend recovery to 3 to 4 months.