Plantar Fasciitis

The Plantar Fascia is a thick band of connective tissue that runs from the bottom of the heel to the bottoms of the toes. Its main function is to provide support for the arch of the foot. It is commonly injured when an athlete increases their workload, changes their shoes, begins to train on harder surfaces or has compensated due to improper training. Some people are more prone to develop it based whether or not they have a pronation distortion, which is more than just flat feet. If not treated properly, pain can cause further compensations, reduce speed, distance and ultimately produce heel spurs. None of which are desirable outcomes as they can stop you in your tracks.

Plantar Fasciitis usually manifests itself in the form of pain in the bottom of the foot, on or near the arch, usually towards the heel. It is commonly worse upon taking the first few steps after sleeping and seems to get better as the day goes on.

The first step to treatment is proper diagnosis and your health care practitioner would be able to do. If you have Plantar Fasciitis, you need to re evaluate what you are doing with your training. Proper training should not lead to injury. Look at the past couple of weeks, have you changed shoes, or should you, increased your workload, done more speed or hill work? How is your form in activities, do your arches fall in when you walk, run etc. A complete biomechanical assessment can offer insight as to why the injury occurred. The cause of injury needs to be removed from your training until you heal. In fact you may need to rest for a week or so until the pain stops as to avoid further injury. A little rest can go a long way.

Stretching your calves is a very important component in recovering from Plantar Fasciitis as it is common to have tight calves and Plantar Fasciitis. Light stretching before activity is encouraged as well as icing after. Strengthening the calf muscles help as well, so calf raises off a step can not only strengthen, but holding the stretch allows you to accomplish two tasks at the same time. Placing a towel on the floor, curling it with your toes, pulling it toward you is a great way to strengthen the muscles on the bottom of the foot. Further strengthening of the quadriceps, hamstrings and glute muscles will also help you run smoother with less impact. The important thing is to recognize any weaknesses before you have the injuries and do the stretching and strengthening as a preventative measure. Wear the right shoes with the right support and don’t increase your work too fast too soon. Remember, proper training should not lead to injury.

Shin Splints (MTSS)

Shin splints are commonly referred to pain in the front inside of the shin usually on the lower third of the leg. They are no longer called shin splints, but rather Medial Tibial Stress Syndrome. If you think you have them, get a diagnosis to rule out stress fractures and compartment syndrome.

MTTS is almost always directly a result of overtraining. Look at your training .You need to re evaluate what you are doing. Proper training should not lead to injury. Look at the past couple of weeks, have you changed shoes, or should you, increased your workload, done more speed or hill work? How is your form in activities, do your arches fall in when you walk, run etc. A complete biomechanical assessment can offer insight as to why the injury occurred. The cause of injury needs to be removed from your training until you heal. In fact you may need to rest for a week or so until the pain stops as to avoid further injury. A little rest can go a long way. The other cause is pronation. As your arches fall, your shins roll inward, putting more stress and strain on the muscles of the lower leg. This causes irritation by pulling the muscles away from the bones they attach to.

MTTS commonly causes pain or discomfort during the start of activity, will get better during and often gets worse at the end or after activity. Icing after activity can help, so can over the counter NSAIDS, but always follow your Doctors advice. Stretching and strengthening appear to be helpful in not only treatment, but also prevention of MTTS. Tightness in the calf muscles can be a factor as well as the calf muscles being too strong. On the flip side if the calf muscles are too weak they can’t handle the stress of impact. Weak muscles on the front of the shin can also be a factor in helping to absorb impact. If the front musculature isn’t able to absorb impact, foot slap occurs. Proper gait mechanics and motion control shoes can help. A balance in strength and flexibility must be maintained.

Runners Knee

Knee pain in runners is a common occurrence. The term “Runner’s Knee” is used to describe painful conditions in and around the knee. The more common term used now is “Patellofemoral Pain Syndrome”, PFPS, which describes the relationship between the patella (kneecap) and femur and their malalignment. PFPS is usually caused by the patella not tracking correctly in the grove of the femur. Pain commonly occurs in or around the patella or at the inside of or below the knee. It is sometimes worse going down stairs or downhill. The main cause of this is; muscle tightness in either the large muscle of the quadriceps, the vastus lateralis or the iliotibial band, wide hips, knock knees or weakness of the smaller muscle in the quadriceps, the vastus medialis. If you are an over pronator, have fallen arches this can add to the problem as well.

If you have PFPS you need to look at your biomechanics. Do you overpronate? Shoes with anti pronation features can help as well. Orthotics can help correct over pronation as well. Some experts have recently suggested off the shelf ¾ length inserts as an alternative to expensive custom fit orthotics. If none of these seem to do the trick you may want to consider a complete biomechanical evaluation to help identify the possible cause. Massage therapy, specifically Active Release Technique, A.R.T., has been shown to help out dramatically. Strengthening the small tear drop shaped muscle of the quadriceps will be crucial to realigning the patella. The vastus medialis is much weaker than its counterpart the vastus lateralis and needs to be strengthened. Be careful of knee extension machines though as most bend the knee to positions that can actually damage the cartilage under the knee cap. The last 30 degrees of extension are where the medialis work the best so avoid a full range of motion if you feel as though you must do them.

Stretching your hamstrings and calves may help as well as overly tight muscles can indirectly add to increased pressure on the knee cap. If you are doing hill work you may need to cut back as hill work can aggravate the injury. Ice or NSAIDS after runs can reduce inflammation, but of course always follow your doctor’s advice.

This information is not intended as a substitute for medical treatment. Before starting an exercise program, consult a physician.




Anthony Preischel
L.M.T. A.R.T. Certified Provide

Clinic Fitness Inc. is a personal training and pre/post rehabilitation clinic. Specializing in postural and movement reeducation, Anthony has worked with countless clients, correcting exercise form, improving performance and strength.

"Incorrect movement patterns lead to compensations which lead to weakness, atrophy and injury", says Anthony, a Certified Trainer with The National Academy of Sports Medicine. He is also a Licensed Massage Therapist who is a certified provider of Active Release Technique. A.R.T. is a highly specialized form of soft tissue treatment that deals with injuries. "If we can correct movement patterns we can get the body to function properly, restoring strength, flexibility and vitality. This prevents injuries and allows the body to heal properly. Not only can we identify improper movement patterns, we can correct them with soft tissue work and proper exercise prescription.This ensures your workouts are not only effective, but safe as well."