Get Back To Running: Treating Plantar Fasciitis

What is Plantar Fasciitis?

https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/multimedia/plantar-fasciitis/img-20006161

Plantar fasciitis is an overuse injury that results from the degeneration or thickening of the collagen fibers in the plantar fascia. The plantar fascia is a band of fibrous connective tissue that runs from your heel bone (calcaneus) to the bases of your toes (metatarsals). It plays a vital role in stabilizing your foot's arch while standing, walking, and running.

The repetitive stress placed on the plantar fascia during running can lead to degeneration and breakdown of the tissue, resulting in pain and discomfort. Although the term "plantar fasciitis" implies inflammation, the condition is more about the degeneration of the tissue rather than inflammation.

Causes of Plantar Fasciitis in Runners

Plantar Fasciitis makes up 5-18% of injuries caused by running [1]. As a runner, it's crucial to recognize the factors that can contribute to the development of plantar fasciitis.

Some common risk factors include [2]:

  1. Weakness in the foot/ankle muscles

  2. Wearing worn-out or improper running shoes

  3. Increasing running volume too quickly

  4. Increasing running mileage

  5. Tight calves and Achilles' tendons

  6. Spending excessive time on your feet (e.g., due to a standing job)

  7. Having excessively high or flat arches

  8. Limited ankle dorsiflexion (pointing ankle upwards)

Symptoms of Plantar Fasciitis

If you're experiencing plantar fasciitis, you may notice some common symptoms, such as [3]:

Goff JD, Crawford R. Diagnosis and treatment of plantar fasciitis. Am Fam Physician. 2011 Sep 15;84(6):676-82. PMID: 21916393.

  1. Pain along the arch and sole of the foot, particularly on the inside edge of the heel

  2. Morning pain that's worse when taking the first steps out of bed but gradually fades as you move around

  3. Pain when pressing along the sole of the foot or stretching the fascia

  4. Development of heel spurs in some cases

Foot and Ankle Pain After Running

Different Causes of Heel or Ankle Pain After Running [1]:

  1. Plantar Fasciitis: As previously mentioned, plantar fasciitis is a common cause of heel pain in runners. The degeneration of the plantar fascia tissue can contribute to pain in the heel area.

  2. Achilles Tedonopathy: Achilles tendinopathy presents as aching posterior heel pain. This is caused by irritation of the Achilles tendon, which connects your calf muscles to your heel bone. Most patients with this condition have pain, swelling, and tenderness on the Achilles tendon 2 to 6 cm above its insertion into the calcaneus. 

  3. Ankle Sprain: Lateral ankle sprains are more common in runners. Pain is usually on the outside of the ankle and can be caused by the ankle rolling inwards during an initial foot strike.

Addressing Heel Pain After Running:

  1. Identify the Cause: The first step in addressing heel pain after running is to identify the root cause by having a comprehensive running assessment to evaluate your running technique, gait, and foot mechanics. This assessment may include video analysis to identify any factors contributing to plantar fasciitis, such as overpronation, excessive foot strike force, or inefficient running form. A functional tests may also be performed to assess your lower limb strength, flexibility, and mobility.

  2. Modify Your Running Routine: Reducing your running volume, incorporating rest days, and adjusting your running form can help alleviate heel pain. Additionally, consider incorporating low-impact cross-training activities like swimming or cycling to maintain your aerobic capacity while giving your heel a break.

  3. Choose Proper Footwear: Wearing the right running shoes for your feet can help reduce the impact on your heel and alleviate pain.

  4. Perform Proper Warm-Up and Cool-Down: Implementing a thorough warm-up and cool-down routine that includes dynamic stretches, muscle activations, and mobility drills can help prep your body for running and minimize the risk of heel pain.

  5. Strengthen and Stretch: Incorporate specific exercises and stretches for your feet, calves, and Achilles tendon into your routine. This can help improve your overall foot and lower leg strength, flexibility, and mobility, reducing the risk of injury.

Here are some examples of foot strength and stretches you can add into your training:

Consistency and patience are key when it comes to treating plantar fasciitis. At Resilience Physical Therapy, we can help you develop a individualized treatment plan that addresses the underlying causes of your plantar fasciitis, such as muscle imbalances, bio-mechanical issues, running form etc. so you can increase your chances of getting back to your regular running routine.

References:

  1. Arnold MJ, Moody AL. Common Running Injuries: Evaluation and Management. Am Fam Physician. 2018 Apr 15;97(8):510-516. PMID: 29671490.

  2. Trojian T, Tucker AK. Plantar Fasciitis. Am Fam Physician. 2019 Jun 15;99(12):744-750. PMID: 31194492.

  3. Goff JD, Crawford R. Diagnosis and treatment of plantar fasciitis. Am Fam Physician. 2011 Sep 15;84(6):676-82. PMID: 21916393.

Exercises to Restore Knee Mobility and Strength

Knee pain can occur in runners and other athletes who undergo high impact and stress on their joints during training and/or competition. Ignoring symptoms can lead to other injuries and may even force an athlete to miss extended time.

Here are some exercises that can help restore knee range of motion, strength, and stability:

🔸SL Fire Hydrant w/ Wall Support

 
 

🔸Rear Foot Elevated Split Squat Hold

 
 

🔸Single Leg bridge

 
 

🔸Couch Stretch

 
 

Disclaimer: These exercises might not help your condition since every injury is multifactorial. Contact us to see if we can help!

Runners: Landing and Force Production Exercises

Running is a series of single-leg jumps from one leg to the other. Training our muscles and tendons to absorb impact and produce force when our feet hit the ground can help improve running speed and prevent injuries.
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Here is a progression of landing and force production exercises you can add to your training:


1️⃣ Bilateral Leg Snap Downs

 
 

Cues: Raise both arms over your head while going onto your toes. Perform a small hop and quickly bring your arms down by your side, landing in a knees-bent, hip-hinged position with both legs. Make sure to pause at the bottom. 

2️⃣ Single Leg Snap Downs

 
 

Cues: Raise both arms over your head while going onto your toes. Perform a small hop and quickly bring your arms down by your side, shift your weight onto one leg and go into a knees-bent, hip-hinged position. Make sure to pause at the bottom, keeping the landing feet, knee, and hip aligned.

3️⃣ Double-Leg Drop to Broad Jump

 
 

Cues: Stand on an elevated surface, step off with one foot, and land onto both legs with knees bent and hips hinged. As you land, jump forward as far as you can with both legs.

4️⃣ Single-Leg Drop to Broad Jump

 
 

Cues: Stand on an elevated surface, step off with one foot, and land onto one leg with knees bent and hips hinged. As you land, jump forward as far as you can with that leg. Try to keep your knees aligned with your toes when landing.

If you are experiencing pain or currently dealing with an injury and need help, contact us for a discovery call!

4 Rehab Exercises For Shin Splints

Medial Tibial Stress Syndrome or shin splints is an overuse injury characterized by pain or tenderness on the inner side of the shin bone (tibia) closer to the ankle. This pain is caused by repetitive stress from the muscles/connective tissues surrounding the shin bone (tibia), leading to inflammation around the bone. This is one of the most frequent injuries occurring in runners with a rate of 13.2-17.3%

Here are four exercises that I like to incorporate into an athlete’s treatment plan:

1️⃣Ankle Dorsiflexion Mobilization

 
 

2️⃣Wall Supported Banded Single-leg Fire Hydrants

 
 

3️⃣Single-leg Hip Airplanes

 
 

4️⃣Single-leg Bridge Holds

 
 

If you are currently dealing with shin splints or experiencing pain when running, we can help!

Shin splints: How to reduce injury risk and return to running

What is Medial Tibial Stress Syndrome, aka Shin Splints?

Medial Tibial Stress Syndrome or shin splints is an overuse injury characterized by pain or tenderness on the inner side of the shin bone (tibia) closer to the ankle. This pain is caused by repetitive stress from the muscles/connective tissues surrounding the shin bone (tibia), leading to inflammation around the bone. This is one of the most frequent injuries occurring in runners with a rate of 13.2-17.3%.

What potential factors can put you at risk of developing Shin Splints?

  • Improper running/training plan

  • Compensatory running mechanics during the stance/swing phase such as increased pelvic drop, knee valgus, internal rotation of the hips, and subtalar joint pronation

  • Muscle weakness and/or joint mobility limitations

How can we reduce the risk of Shin Splints and get back to running?

If you are currently dealing with shin splints or experiencing pain when running, we can help!

References:

  • Lopes, A.D.; Hespanhol Junior, L.C.; Yeung, S.S.; Costa, L.O.P.; Hespanhol Junior, L.C.; Yeung, S.S.; Costa, L.O.P. What are the main running-related musculoskeletal injuries? A Systematic Review. Sports Med. 2012, 42, 891–905.

  • Menéndez C, Batalla L, Prieto A, Rodríguez MÁ, Crespo I, Olmedillas H. Medial Tibial Stress Syndrome in Novice and Recreational Runners: A Systematic Review. Int J Environ Res Public Health. 2020 Oct 13;17(20):7457. doi: 10.3390/ijerph17207457. PMID: 33066291; PMCID: PMC7602098.

Improving Rotator Cuff Stability: Shoulder Taps

The shoulder tap exercise targets the rotator cuff muscles and other muscles around the shoulder isometrically. This makes it an excellent entry point to improve shoulder stability, especially if dealing with an injury such as shoulder impingement or rotator cuff strain/tendinopathy

When performing shoulder taps, ensure your chest is positioned over your hands, keep elbows fully extended, and neutral spine. Make sure to keep body sway to a minimum

Here is a shoulder tap exercise progression:

🔸Perform 3 sets of 10-12 reps on each arm

 
 

1️⃣Shoulder Taps on Knees

 
 

2️⃣Shoulder Taps on Elevated Surface

 
 

3️⃣Shoulder Taps in Push-up Position

 
 

4️⃣Shoulder Taps in Bear Crawl Position


If you are experiencing shoulder pain or currently dealing with an injury, we can help!

Training Your Muscles Eccentrically For Downhill Running

Eccentric exercises mimic the muscle lengthening action we rely on when running downhill. Performing eccentric strength training has been shown to limit the effects of exercise-induced muscle damage caused by downhill running and maximizes strength production.

Here are some eccentric exercises to incorporate into your training:
🔸Perform movements slow and controlled, focusing effort on the way down
🔸3 sets of 8-10

1️⃣Eccentric Single-Leg Box Squat

 
 

2️⃣Eccentric Anterior Step-Down with Slant Board

 
 

3️⃣Eccentric Single-Leg Hamstring Curl with Foam Roller

 
 

4️⃣Eccentric Single-Leg Hip Thrust

 
 

5️⃣Eccentric Single-Leg Heel Raises

 
 

6️⃣Eccentric Single-Leg Soleus Heel Raises

 
 

If you are experiencing pain when running or currently dealing with an injury and need help, contact us for a discovery call!

References: Douglas J, Pearson S, Ross A, McGuigan M. Chronic adaptations to eccentric training: a systematic review. Sports Med. 2017;47(5):917–41.
Saunders PU, Pyne DB, Telford RD, Hawley JA. Factors affecting running economy in trained distance runners. Sports Med. 2004;34(7):465–85.
Barnes KR, Kilding AE. Strategies to improve running economy. Sports Med. 2015;45(1):37–56.

Reverse Nordic Curls To Improve Tight Hip Flexors

The Reverse Nordic Curl is a great way to strengthen the hip flexors eccentrically and address hip tightness due to muscle weakness

When performing this exercise, keep your rib cage down when performing this exercise, and engage your core to maintain a neutral spine throughout the motion. Start with band assist and progress to no assistance when you can maintain proper form.


1️⃣Reverse Nordic Curls with Band Assist

🔸Perform 3 sets of 8

 
 

2️⃣Reverse Nordic Curls

🔸Perform 3 sets of 8

 
 

Give these a try! If you are experiencing pain or currently dealing with an injury and need help, contact us for a discovery call!

3 Exercise Variations To Improve Ankle Stability

Why should you train ankle stability?

Single-leg ankle stability is essential for any sport that involves running, accelerating, decelerating, and lateral motions. Improving SL ankle stability is especially important for returning to sport after a repetitive stress injury such as plantar fasciitis, post tib tendonosis, and medial tibial stress syndrome (shin splints)

Here are 3 single leg RDL exercise variations that will challenge your ankle stability:

🔸Perform 3 sets of 8 repetition
1️⃣SL RDL balance with arm
2️⃣SL RDL to knee drive
3️⃣SL RDL with hip rotation

 
 
 
 
 
 

If you are experiencing pain or currently dealing with an injury and need help, contact us for a discovery call!

Warm-Up Circuit to Improve Your Front Rack Barbell Position

The front rack position is required when performing lifts such as cleans, front squats, and push presses. This position requires thoracic spine extension, lat muscle flexibility, and shoulder external rotation mobility.

Here is a quick warm-up circuit to prep your shoulders and spine for the front rack position:

Perform 3 Rounds
1️⃣Thoracic Extension w/ Elbow Flexion and Extension - 5x
2️⃣Thoracic Extension w/ Shoulder Lift Offs - 5x
3️⃣Front Rack Elbow Wall Slides - 5x

Give these a try!

 

Thoracic Extension w/ Elbow Flexion and Extension

 
 

Thoracic Extension w/ Shoulder Lift Offs

Front Rack Elbow Wall Slides

 
 
 

Plyometric Exercise Progressions For Running Speed and Efficiency

Why should you start doing plyometric exercises?

Plyometric exercises are a great way to improve your rate of force development and energy storage through your tendons. This translates into faster and more efficient running by increasing your maximal force output when your foot hits the ground.

Here is a plyometric exercise progression starting from easiest to hardest:

 

Jump Lunges w/o Switch

 
 

Jump Lunges w/ Switch

 
 

Single Leg Sprint Jumps

 

If you are interested in working with us, schedule a free discovery call!

3 Core Exercises To Improve Your Running Form

Maintaining trunk stability throughout your run is crucial for efficient form.

Here are some exercises that will not only work on your core but also challenge coordination and motor control between your arms, legs, and trunk:
Perform 3 Rounds

1️⃣ Pallof Press with Marching - 15x each leg
2️⃣Push-up Position with Hip Marches - 20x each leg
3️⃣Thread The Needle into 90/90 Leg Position - 8x on each side

 

Pallof Press with Marching - 15x each leg

 
 

Push-up Position with Hip Marches - 20x each leg

Thread The Needle into 90/90 Leg Position - 8x on each side

 

If you are interested in working with us, schedule a free discovery call!

Runners: 3 Strength Exercises to Incorporate Into Your Training

 

Why you should add single-leg exercises into your workouts

Running is essentially jumping from one leg to the other repeatedly. That is why efficiently absorbing load through a single leg is crucial.

Here are 3 strength exercises incorporating single leg loading to help improve your running:

1️⃣ Loaded Marches - 3 x 30-40 seconds

 
 
 

2️⃣ Band Single Leg RDLs - 3 x 10

 
 

3️⃣ Front Rack Reverse Lunges - 3 x 10

 
 

Overhead Shoulder Warm-Up Exercises

I usually have issues with end-range shoulder flexion during overhead loading, these exercises help prepare my shoulders by increasing my range of motion and stability in those positions.

Here are some of my go-to warm up exercises that I use to prep my shoulders for overhead lifts. Use light to medium weights (this is just a warm-up)

1️⃣ Thoracic Extension + Unilateral Elbow Liftoff

🔸Find an elevated surface to rest your elbows on
🔸With both hands touching your shoulder drop your chest towards the floor while maintaining a neutral spine
🔸Lift one elbow off the surface and hold for 5 seconds

 
 

2️⃣ Landmine Shoulder Rotations

🔸Start at end-range shoulder flexion with neutral spine
🔸Lower the barbell to one side and bring it back up, make sure the motion is slow and controlled

 
 

3️⃣ Bottoms-up Kettlebell Presses

🔸Start at a 90/90 elbow/shoulder position
🔸Press dumbbell up into end range shoulder flexion and hold for 5 seconds