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  • Dori Nissenson

Summer Series - Part 1

Summertime, and the livin's easy?

With Spring underway and summer on the horizon, a lot more folks are exercising more intensely, engaging in seasonal activities such as swimming and golf and, in general, taking their activity outdoors. Along with this shift from the gym to the outer world, and participating in different forms of exercise and exercising more frequently and at higher levels of intensity, comes the risk of sports-related aches, pains, and injuries. Over the next four months, I will be writing a series of blogs about the most common injuries that exercise junkies and athletes tend to incur during the warmer months.

This letter will focus on the feet, and I will discuss plantar fasciitis.

What Is Plantar Fasciitis???

The plantar fascia is the thick fibrous band of tissue that connects your heel to your toes.

These tissues support the muscles and the arch of the foot.

Overstretching of the plantar fascia can lead to tiny tears in the tissue causing pain and inflammation in the fascia resulting in plantar fasciitis.

What Causes Plantar Fasciitis???

There are many causes of plantar fasciitis, and in my practice, I see an increase in this diagnosis during the warmer months. I like to call it “summer feet”. The most common causes of “summer feet” are:

1. Change in running routines: During the warmer months, many runners increase their frequency of running and increase their mileage.

2. Change in the environment: Many of us spend our days in the “off” season running indoors on a treadmill or a track. The shift to outdoor terrain can cause pain and inflammation of the plantar fascia resulting in plantar fasciitis.

3. Change in shoewear: During the summer many of us wear sandals or flip flops or shoes that have less support than our cold weather wear.

4. Disuse of orthotic devices: Summer shoes such as sandals and flip flops cannot accommodate orthotics, and many orthotic wearers forego using their orthotics to be able to wear sandals in the warm weather.

What Are The Signs And Symptoms Of Plantar Fasciitis???

1. Foot pain and discomfort 2. Pain with the first few steps out of bed in the morning 3. Pain in one foot, not both 4. Severe pain in your foot after exercise or after being on your feet for a prolonged period of time 5. Tight Achilles tendons 6. Tight calf muscles

How Can You Treat Plantar Fasciitis???

If you feel that you may have plantar fasciitis, it is imperative that you seek the help of a physical therapist.

If plantar fasciitis goes untreated, it will worsen and may end up being resistant to conservative treatment.

After a thorough evaluation, your physical therapist may do the following:

1. RICE: In the acute stage, your PT will recommend that you rest from the activity that has potentially caused your pain, ice the plantar fascia, and elevate the foot to decrease any swelling that has accumulated in your foot. Compression is more challenging in the foot but your PT may use tape to achieve the same pain-reducing result.

2. Deep tissue work: Your PT will use advanced manual soft tissue mobilization to the plantar fascia to increase blood flow to the area that will help with healing. 3. Stretching: Your PT will perform and instruct you in stretches for your plantar fascia, Achilles tendon, and calf musculature as well as other muscles of the leg that may be contributing to your pain.

4. Strengthening: Your PT will instruct you in strengthening the muscles of the bottom of your foot that interdigitate through your plantar fascia. Strengthening these muscles will reduce stress on the plantar fascia.

5. Joint work: Your PT will address the biomechanical alignment of your feet: Do you have flat feet or high arches? People with both foot types are at risk for developing plantar fasciitis and may require joint mobilization in different areas of the foot.

6. External support: Your PT may tape your foot to reduce the stress on your plantar fascia. He or she may also fabricate custom orthotics to improve the biomechanical alignment of your foot and limit the stress on the plantar fascia.

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