Plantar fasciitis is one of the most common disorders of the foot, yet its causes are poorly understood and it is probably due to many different issues. Plantar fasciitis is inflammation of the plantar fascia; this is the soft tissue that runs from the forefoot and attaches into the heel. Its function is to support and stabilise the foot during loading and at toe off. Pain is experienced under the heel or arch and is usually worst first thing in the morning or walking following a period of rest. It is caused by abnormal function of the lower limb due to structural malalignment, muscular weakness or imbalance.

Treatment by your Sports Podiatrist involves rest, icing, strapping, stretching and soft tissue release, addressing abnormalities in leg and foot function maybe using orthotics, the right shoes and stabilisation exercises. Heel spurs can develop over time when there is excessive tension of the plantar fascia on the heel bone. Symptoms usually coincide with plantar fasciitis, however, pain is usually more pin point to the heel bone and usually also at the end of the day.

TREATMENT PLAN
Phrase 1: Stabilisation

Phrase 2: Soft tissue release and acute injury management

Phrase 3: Strengthening and stretching program (upon zero pain)

When walking and at the moment the heel of the trailing leg begins to lift off the ground, the plantar fascia endures tension that is approximately two times body weight!

The plantar fascia encapsulates the muscles in the sole of the foot and has three bands or sections, based on the muscles they surround: the medial (inside edge of the foot), central, and lateral (outside edge of the foot). Plantar fasciitis is defined as an inflammation of the plantar fascia, with “Plantar” meaning the bottom of the foot, “fascia” is a type of connective tissue, and “itis” means “inflammation”. It is associated with causing destruction of blood vessels in the area and the formation of fascia scar tissue, which can adhere to other tissues in the area. This slows future healing and inflicts more pain (and damage) when the fascia is under stress, as scar tissue is not as flexible and strong as the original tissue.

CAUSES
Plantar fasciitis is common in sports which involve running, dancing or jumping. Runners who over-pronate (feet rolling in or flattening) are particularly at risk as the biomechanics of the foot pronating causes additional stretching of the fascia.

The most common cause is very tight calf muscles which leads to prolonged and/or high velocity pronation of the foot. This in turn produces repetitive over-stretching of the plantar fascia leading to possible inflammation and thickening of the tendon. As the fascia thickens it loses flexibility and strength.

Other causes include low arch or high arched feet (pes planus / cavus) and other biomechanical abnormalities including over-supination which should be assessed by a sports podiatrist.
Excessive walking and running in footwear which does not provide adequate arch support has been attributed. Footwear for plantar fasciitis – both prevention and treatment – should be flat, lace-up and with good arch support and cushioning.

TREATMENT
What can the athlete do?

Management of plantar fasciitis must be immediate, as it’s very hard to treat once it is established i.e., ‘it won’t go away by ignoring it’ or by ‘training through it’. Hence, the earlier it is assessed and managed, the less debilitating it will become.

• Ice: Regular application of ice throughout your day after your activities is crucial to provide pain relief and minimiSe associated secondary soft tissue damage.

• Non-Steroidal Anti-InflaMmatories: Will assist in minimising the sensitivity, and thus the pain, of the plantar fascia. These will need to be prescribed by your sports physician / general practitioner.

• Tape / flexible orthotics: Can help to protect the fascia and increase the arch support, allowing it time for healing to occur. Orthotics can help correct biomechanical issues that are predisposing you to over using your plantar fascia for support.

• Stretching: Is usually recommended and often the only thing that can help, especially in those with sedentary desk jobs. Poor gastrocnemius / soleus muscle flexibility can overload the plantar fascia, and hence, a regular stretching program to maximise their length is essential for correct foot / ankle function. In cases where plantar fasciitis is caused by a sudden injury, stretching may re-injure the fascia if not done carefully.

• Muscle release/massage: Especially in the morning and before activity, as this will act to improve local blood flow and tissue flexibility by ‘warming’ the area. Massage will assist in releasing adhesions between the collagen fibres that compose the plantar fascia, therefore causing less damage to the heel and fascia when walking.

• Increase strength: by a series of graduated exercises to the muscles of the foot and lower leg to improve the ability of the plantar fascia to withstand the forces developed when walking and performing sporting activities.

Erin Lorenzini-Todd
Sydney East Podiatry & Lower Limb Sports Injury Clinic
sydneyeastpodiatry.com.au

There is no traditional rubber on the underside of the shoe, instead the protection is provided by a revolutionary type of EVA foam, this saves weight and its springiness creates a quite unique feel when you run.

I popped a pair on for a recent treadmill session when the shoe came into the store. The Virrata feels light, energetic and easy to run in. I also felt like I was more positively conscious of my foot strike, yet felt comfortable that the cushioning under the midsole would save me if fatigued.

I’ll definitely be adding this shoe to my repertoire, I currently race and do most of my training in Saucony’s Kinvara 3, but the Viratta offers something slightly different and is an ideal shoe to bridge the gap between a more traditional running shoe and minimalist footwear.

Personally, as an Olympic and middle distance triathlete, who is often running off the bike and therefore fatigued, I wouldn’t opt for this shoe, or any minimalist shoe, for every race, but definitely bring it out for interval training sessions as well shorter races and 5km and 10km hit outs.

Weight:
194g size 9US (weighed in store)
164g size 7US (weighed in store)

Heel Height: 20.6mm
Forefoot Height: 20.6mm
0mm Differential

Nik Howe
Australian Cross Triathlon Age Group Champion
Image courtesy of Saucony

Traditional running shoes are well cushioned, have built-in support to prevent injury, and a high heel to toe drop, meaning the heel is elevated 8-12mm above the toe. Minimalist footwear doesn’t impede upon the body’s natural biomechanics, and typically sits on 0mm platform, meaning there is little to no cushioning between you and the surface beneath you.

At The Running Company, we provide state-of-the-art digital gait analysis to ensure you’re running in the correct footwear, but if your ultimate goal is to run barefoot or in natural motion shoes, then a new wave of transition runners have hit the store, which, in the right circumstances, could help you achieve the goal of minimalist running.

Which shoe should I start off with?
A transition shoe is a good shoe for most runners taking their first step towards natural motion running. It has a lower heel to toe drop and less cushioning than a traditional running shoe.

I have started the transition but my calves and feet are sore. Should I go back to my old shoes?
In a more minimalist shoe your feet, calves and Achilles must work harder to manage your landing, which requires stronger muscles and more flexible tendons. Keep the kilometres low in your transition shoe and alternate back to your previous shoes for some of your training, adopting a more cautious approach.

Should I change my running form if I am not hurt?
We digitally assess your gait at The Running Company and won’t be put you in a transition shoe or more minimalist footwear unless they are right for you. If you are running injury free with a good forefoot/midfoot landing there is no need to change anything.

Should everyone aim to be wearing natural motion shoes?
The goal of running is first and foremost to enjoy it and run injury free. Everyone is different and very few runners will be able to make the full transition for all their running and even fewer are strong enough or desire to run barefoot. We suggest a gradual reduction in the cushioning and heel-to-toe drop of your shoes until you are at your individual goal – be it more enjoyable running, better performance, or for some experiencing the joy of barefoot running.

Can I just start running in minimalist shoes all the time?
If you change from traditional runners to minimalist footwear you are likely to get injured due to the stresses on your body. Developing a more natural running style requires a gradual transition to increasingly minimalist shoes. We highly recommended visiting the store for an expert gait analysis appointment so we can suggest the best runners for you.

What transition shoes would you recommend?
It depends on the runner, but Brooks, New Balance, Newton, Saucony and Nike have all recently released transition shoes, with lower heel to toe drops, that could help you achieve your goal of natural motion running.

Image courtesy of New Balance

Spend at least 15-20 minutes on the following essential foam roller stretches for runners and triathletes and you will see the benefits.

ITB
• Lie on your left side with your outer thigh on the foam roller, and left forearm propping up the torso.

• Roll between the knee and the hip bone, taking extra time on points of tension. If this is too uncomfortable, place the top foot on the ground to decrease the weight on the roller.

• Continue for 30-60 seconds and swap sides.

HIP FLEXORS
• Start facedown on the floor with both thighs on the roller, and forearms propping up the torso.

• Roll up and down, spending extra time on points of tension or knots.

• Spend 30-60 seconds on each thigh.

HAMSTRINGS
• Begin in a seated position with both thighs on the roller, and your hands propping you up by your side and slightly behind you.

• Roll out the hamstrings down to the knee and back, increasing pressure if required by lifting one thigh off the roller at a time.

• Continue for 30-60 seconds on each hammie.

CALVES
• Sit with your legs extended, left ankle on the roller with your hands propping you up by your side and slightly behind you.

• Cross your right ankle over your left, and roll the body back and forth, ensuring you roll the entire length of the calf – both inside and out.

• Roll for 30-60 seconds and then swap sides and repeat.

GLUTES
• Sit with the right ankle crossed over the left thigh, and place your left foot firmly on the floor with your hands propping you up by your side and slightly behind you.

• Roll the body back and forth, easing the tension in each part of the glute.

• Roll for 60 seconds on each side, applying extra pressure on any points of tension.

UPPER BACK
• Lay on your back with the roller under your shoulder blades and your knees bent, and cross your arms across your chest.

• Engage your core and raise your hips off the floor, ensuring your head and neck are kept still and in a neutral position.

• Roll for 30-60 seconds until the back feels released.

LATS
• Begin lying on your left side with the roller under your armpit and the left arm extended flat on the floor.

• Place your right arm in front of you for balance, and begin rolling out your lats.

• Roll for 30-60 seconds and repeat on the other side.

CHEST
• Begin laying facedown with the roller under the left side of your chest.

• Roll across the left pectoral muscle, taking extra time on points of tension.

• Roll for 30-60 seconds and repeat on the other side.

Images courtesy of Trigger Point Therapy

Cranbrook is steep and twisty and it doesn’t all finish there with some small undulations on Victoria Road as well. Then, a nice easy downhill onto Birriga Road to bring you home.

For those with problems running downhill or tight quads or calves, look to wear a set of compression tights or calf sleeves to help keep everything moving well and for recovery after.

This run is just over 7km, it’s a great mix of up hill, downhill and some nice flats as well. To really mix it up, look to run a couple of repeats up and down Cranbrook if you’re keen!

Mapped: Hill Running for Strength 

BLOOD: Running helps your blood flow better, which in turn helps keep the blood vessels clean.

BODY: Running burns more kilojoules than most sports so is great for weight loss and will keep you lean.

BRAIN: Many of us can testify to how a good a run is for letting off steam after a hard day, but it’s a fact that running stimulates the brain and the oxygen supply, which can improve concentration and creativity.

CONFIDENCE: Every run is time not spent on the couch or boozing at the pub and is therefore a success story. Success stories give you confidence. Confidence makes you feel good. Done.

CIRCULATION: Running boosts your circulation, helping develop new capillaries and improve nutrition transport.

HEART: Regular training can cut your risk of a heart attack in half. Do we need to say anymore.

LUNGS: Running is great for improving lung function. The amount of air you inhale and exhale improves with each breath.

MUSCLES: Your muscles will work better because the oxygen is transported easily. Running also helps strengthen the muscles throughout your entire body.

RELAXATION: Running reduces stress. Period.

SEX LIFE: The worse people’s health is, the more likely they are to either have sexual problems, or not have sex at all. We say, why are you reading this, get out and run.

Image courtesy of Brooks Running

At The Running Company Bondi Beach, we see ourselves as part of the running community and The Pulse is our online platform to share information, exciting announcements and expert advice with the community – be that runnings tips, shoe reviews, new gear and tech announcements, recovery and nutrition advice, playlists or great local run routes.

You don’t have to be an expert runner to enjoy The Pulse either. It might be that you’ve started running to lose weight, get fit again or raise money for charity. Alternatively, you could be a serial marathon runner with a personal best that puts Paul Ryan to shame. Or, like many of us, you could be somewhere in the middle, and keen to crack another PB.

It won’t just be us blogging either, we’ll have guest posts from health professionals, shoe reviews from pros and seasoned runners, advice from running and triathlon coaches and, of course, articles from punters, too.

We would also like The Pulse to be a two-way conversation, so feel free to comment, opinionate and debate. All we ask is that you keep it clean, don’t make it personal and don’t say anything you wouldn’t say in public, or to your Nonna.

So welcome, and make sure you come back soon.

Image courtesy of New Balance