Key Points Symptoms of Plantar Fasciitis in Runners:
Heel Pain:
- Sharp, stabbing pain in the heel, especially in the morning or after periods of rest
- Pain may subside as the day progresses and the fascia warms up
Arch Pain:
- Pain can radiate into the arch of the foot, causing discomfort and tenderness
Pain Intensity:
- Ranges from a dull ache to a sharp, stabbing pain
- Can be constant or intermittent depending on activity level and stage of condition
Pain Triggers:
- First steps in the morning (due to stiffness in the plantar fascia)
- After prolonged sitting or standing
- During and after physical activity, especially at the "push-off" phase
Severity Indicators:
- Frequency of pain: From occasional post-run pain to persistent pain throughout the day
- Intensity of pain: From mild discomfort to debilitating, sharp pain
Progression of Symptoms:
- Initially, heel pain may only occur after runs
- Can progress to pain at the start of a run, subsiding during the activity but returning afterward
- In severe cases, pain may persist even during the run and cause limping in the morning
As a runner, you've noticed a nagging pain at the bottom of your foot that's been lingering for a few weeks. It's starting to impact your running routine, and although it's not severe enough to make an immediate visit to the doctor, you're eager to address it before it escalates.
You suspect it might be plantar fasciitis, a common injury in the running community, but you want to confirm this before dedicating time to a treatment plan.
While the symptoms of plantar fasciitis in runners are similar to those experienced by the general population, they can be more pronounced and challenging due to the repetitive nature of running and the significant stress placed on the foot and ankle.
In this article I want to bring you through some common symptoms you may have if your suffering from plantar fasciitis.
Where is the Pain of Plantar Fasciitis Located?
Heel Pain: The most common symptom of plantar fasciitis in runners is a sharp, stabbing pain in the heel. This pain is often most intense in the morning or after periods of rest, when the plantar fascia is stiff and less flexible. As the day progresses and the fascia warms up, the pain may subside or become more manageable.
Arch Pain: The pain associated with plantar fasciitis can also radiate into the arch of the foot, causing discomfort and tenderness when touched. This arch pain can be particularly troublesome for runners, as it can affect their gait and running mechanics.
What Does the Pain Feel Like?
People often complain of sharp stabbing pain, particularly after a long period of being off their feet.
Usually, people describe their first morning steps as "walking on eggshells."This sharp stabbing pain typically lasts for the first few steps and then slowly subsides.
As plantar fasciitis progresses, some may complain of a dull ache or burning sensation at the bottom of their feet. Depending on the stage of plantar fasciitis and the person's activity level throughout the day, this can range from an on-and-off dull ache to aching throughout the day. It can be constant after being on their feet for a long time or after a run.
The pain is often worse barefoot than in shoes, caused by an unsupported arch.
What Activities Will Cause Pain
Pain with plantar fasciitis is usually associated with activities that cause stress on the plantar fascia. It doesn't mean you need to avoid them. However, you should be aware as it can help diagnose your plantar fascia and know what to expect.
Your First Steps in the Morning
One common symptom experienced is an extra burst of pain when they first step out of bed in the morning.
While we sleep, we often point our toes down. It's natural. However, this shortens the plantar fascia.
During this time, the plantar fascia becomes stiff. When we get our of bed our weight on it, suddenly, stretching the plantar fascia causing pain.
A morning routine to stretch the plantar fascia or night splints to keep your plantar fascia stretched throughout the night can help curb this pain.
A Period of Prolonged Sitting
Sitting for a long time can cause increased pain after you stand up.
Like sleeping, your plantar fascia will shorten and become stiff when you don't have pressure through your feet.
When you stand up, your body weight suddenly stretches the plantar fascia.
The pain after standing in this scenario is often less intense than your first steps in the morning because you aren't sitting as long (unless you sit for 7-8 hours straight!).
Standing for a Prolonged Period
If you have plantar fasciitis, standing for extended periods can put a lot of pressure and strain on your feet.
Prolonged standing causes your arch to flatten, slowly putting strain on the plantar fascia.
This cumulative strain can lead to dull pain and stiffness in the bottom of your arch.
Properly fitted insoles for plantar fasciitis or shoes that have good arch support and cushion can help to support the arch and combat the pain of prolonged standing.
Worsening Pain with Exercise
The pain associated with plantar fasciitis often intensifies with exercise.
Exercise can place a lot of strain on the plantar fascia on the bottom of your foot. A lot of different physical activities require us to push off with our feet.
Pushing off shortens the arch, causing a high strain on the plantar facia. Often, people will particularly feel pain during the “push off” phase of activities, like just before you jump or with running just before you begin your stride.
Walking or Standing on Toes will Increase Pain
Standing on your toes can cause increased arch pain in individuals with plantar fasciitis.
When we are on our toes, the arch shortens, causing stress through the plantar fascia.
Activities like reaching into a tall cupboard or going into a deep squat to get into a low cabinet can be painful.
Symptoms of Plantar Fasciitis While Running and Severity
Plantar fasciitis can range in severity, from mild discomfort to debilitating pain, and understanding the nature of your symptoms is crucial in determining the extent of your plantar fascitiis.
As a runner, it's essential to closely monitor the frequency and intensity of your plantar fasciitis symptoms, as this will guide you in managing the condition effectively.
The Frequency of Pain
The frequency of the pain can be a reliable indicator of the severity of your plantar fasciitis. In the initial stages, you may only experience pain associated with plantar fasciitis after a run or other high-impact activity.
As the condition progresses, the pain may become more persistent, occurring even at the start of a run and gradually subsiding during the activity, only to return afterward.
The Intensity of Pain
In addition to the frequency, the intensity of the pain is also a crucial factor in assessing the severity of your plantar fasciitis.
Mild cases may present as a dull ache or discomfort, while more severe cases can involve sharp, stabbing pain that persists even during periods of rest or light activity.
Progression of Symptoms
As a runner, you may initially experience heel pain after a run, which can gradually worsen over time. In more advanced stages of plantar fasciitis, the pain may become sharper and persist even throughout your run.
In the later stages, the discomfort may become so intense that you may limp until you have taken a few steps in the morning, particularly after a period of non-weight-bearing.
Understanding the Implications
The more severe your plantar fasciitis symptoms, the longer it typically takes to heal. Runners with more frequent and intense pain are likely dealing with a more advanced stage of plantar fasciitis, requiring a more comprehensive treatment approach.
By closely monitoring the progression of your symptoms, you can take proactive steps to address the issue, potentially preventing it from becoming a chronic or debilitating problem.
By recognizing the frequency and intensity of your plantar fasciitis symptoms, you can better gauge the severity of your condition and take the necessary steps to manage it effectively.
This knowledge can empower you to seek timely and appropriate treatment, ensuring a swift and successful recovery and a return to your running routine.
Plantar Fasciitis Versus Similar Conditions
It is important to note that many other conditions can present similar to plantar fasciitis and cause foot pain.
The some diagnosis mistaken for of plantar fasciitis include:
Plantar Fasciitis
Versus
Similar Conditions
Plantar Fascia Rupture vs Plantar Fasciitis
Cause
- Plantar Fasciitis: This condition is typically caused by chronic inflammation and microtears in the plantar fascia ligament.
- Plantar Fascia Rupture: A rupture is characterized by a sudden, traumatic tear or complete rupture of the plantar fascia. This acute injury often occurs during high-impact activities such as jumping or falling, which place excessive stress on the fascia.
Pain
- Plantar Fasciitis: The pain associated with plantar fasciitis is typically a sharp, stabbing sensation that is most intense during the first steps after waking up or after long periods of rest.
- Plantar Fascia Rupture: The pain from a plantar fascia rupture is immediate and severe, often described as a sharp, excruciating pain that occurs at the moment of injury. It is often accompanied with swelling and bruising.
Symptoms
- Plantar Fasciitis: The hallmark symptom is pain that is worst with the first steps in the morning or after periods of rest, which generally improves with movement as the tissue warms up.
- Plantar Fascia Rupture: This injury causes immediate and severe pain at the time of the incident, often accompanied by an audible “pop” or “snap” sound. Significant bruising and swelling in the arch or heel area typically follow.
If your plantar fasciitis is not getting better, worsening, or causing you to limp it is not a bad idea to visit a local doctor of physical therapy or a physician. A skilled medical professional perform a thorough evaluation and use their medical knowledge to determine the specific cause of your pain and develop an appropriate treatment plan.
Conclusion
Plantar fasciitis is a common and often frustrating condition for runners. It is important to understand the symptoms and severity of the condition to treat it properly. Symptoms of plantar fasciitis include sharp stabbing pain in the heel and arch and a dull ache in the bottom of the foot. Pain is often worse when standing or walking barefoot and can be associated with activities like getting out of bed in the morning or standing up after sitting. The frequency and intensity of the pain can indicate the severity of the condition. Catch it early!
Tu P. Heel Pain: Diagnosis and Management. Am Fam Physician. 2018 Jan 15;97(2):86-93. PMID: 29365222.
Baravarian, Bob. "A Guide To The Differential Diagnosis Of Heel Pain." Podiatry Today, HMP Global Learning Network, May 2009. URL: https://www.hmpgloballearningnetwork.com/site/podiatry/a-guide-to-the-differential-diagnosis-of-heel-pain