While any experienced runner will tell you there are quite possibly hundreds of different aches and pains associated with long distance running, the one that has sent them running to their podiatrist most often is a condition known as Plantar Fasciitis (pronounced Fah-shee-eye-tis).  This “sore spot” with runners is often caused by biomechanical flaws such as flat feet (where excessive pronation occurs with every step) and high arched feet (where the Achilles tendon is excessively tight).  But you don’t have to be born with a biomechanical problem to suffer from plantar fasciitis.  Many of us are our own worst enemy, bringing on this condition by overtraining, excessive weight gain and wearing the wrong shoes while not running.  That’s right, wearing the wrong shoes at work and going barefoot on hard floors at home and outside by the pool.  And of course, you know about those extra couple of pounds that you put on after increasing your mileage (and your appetite)! The combination of any or several of these mentionables is enough to make you writhe in discomfort with every step.  And the longer you wait to get treatment, the longer it takes to get rid of that agonizing pain that is now becoming a constant part of your daily life. 

If you have never had this condition and are now experiencing heel and/or arch pain, stiffness and tenderness at the bottom of your foot (or feet) upon the first few steps in the morning, and even pain that seems to be radiating from the bottom of your foot and up into your leg, you need to read on.  Instead of ignoring the pain and trying to “run through” it, I want you to think about and follow the next few steps which will help you evaluate your condition and determine at what point you need see a podiatrist.

First, go to your closet take out all the shoes that you commonly wear during a normal work week. Aside from your running sneakers, determine which shoes you wear most often.

Men, do you wear those heavy black “men’s oxford” type shoes to work?  You know, the ones with the hard innersole?  How about those backless pool ‘slip-ons’ or loafers or moccasins?  These all might be contributing, step by step to your ever-increasing torture that has become a daily experience.

Ladies, you are usually worse than us men, your stylish work shoes, heels, backless shoes and the fact that your “sexy looking” shoes generally squeeze your foot into about two-thirds of the amount of width that you really need, all add up to trouble.

So, here’s the plan: First, both men and women, if you must wear a fancy shoe to work, try and find a comfortable shoe, like a Rockport, and replace the sockliner with an extra soft, rubbery innersole.  You know, the kind you can buy at your local running or sports store.  When not at work, wear an older pair of running sneakers around the house and again, replace the sock liner with a sport type aftermarket innersole. You can use the same innersoles that you use for your work shoes.

At this point, do not use a plastic orthotic device or any prefabricated devices that you might buy in a store. These are generally not made for your foot and can sometimes worsen a bad situation. Lastly, NO BARE FEET.  Wear your sneakers in and out of the house (ok, not in the shower), but you get the picture? You need to have support and softness as well as a small heel lift to try and alleviate stress and to help distribute weight a little more efficiently.  For those of you that can take an anti-inflammatory medicine such as ibuprofen, you might try using it for a week or so.

Now as a long-distance runner and a podiatrist, I am at odds to tell you that reducing your mileage, at least for a week or two, might certainly help.  Lord knows, that’s the last thing you want to hear!  But if, after that amount of time, the condition has not improved, that is the time to be examined by your podiatrist.

The treatment of plantar fasciitis can certainly be more complicated than I have described above, and it often takes time to resolve the condition.  Methods such as injections, custom casted orthotics, physical therapy and strappings are often used to alleviate pain.  The sooner you receive treatment, the faster you will get back on the road pain free.

See you on the road!!!

Cary
Dr. Cary M. Zinkin, Podiatric Physician