CRNs very own Lee Miller recently wrote an excellent article on Plantar Fasciitis (PF) which I’d like to use as a starting point for today’s article. What prompted me to write on this subject is that lately I’ve noticed a few people (like our editor, Jeanne) suffering from PF.
Disclaimer: I’m not a doctor. In fact, I have no formal medical training. What I am is a longtime runner who’s made nearly every mistake in the book (wisdom comes from experience?). I’m also fairly proficient in discussing the Pose Method of Running – a method that looks at running differently than other approaches.
Excerpts from Lee’s article (please read the whole article if you want the full explanation):
1. What is Plantar Fasciitis?
The plantar fascia is a band of fibrous tissue at the bottom of the foot extending from the heel to the ball of the foot. This structure plays a major role in supporting the arch and preventing the foot from collapsing under the weight of the body … feels like a heel bruise and usually presents with tenderness along the bottom of the foot. A certain amount of swelling or even a small lump may be associated with the painful area. The hallmark sign of this injury is that the first steps out of bed in the morning are usually the most painful.
2. What are the causes/predisposing factors of injury?
…one reason is running too much on the toes…
4. What can be done to prevent or treat this injury?
Prevention is targeted at stretching and strengthening the muscles in and around the foot and reducing the stress on the plantar fascia.
Before I get into my schpeel, let’s start with some graphics to enhance Lee’s words:
Let me first say that what Lee wrote is correct (who am I to argue?). However, I’d like to suggest that this widely accepted method for preventing PF (to stretch and strengthen muscles) is not, according to the Pose Method, the only route to solving the problem.
The Pose Method approach to solve PF has a connection to Lee’s other suggestion: “reducing the stress on the plantar fascia”. Pose does this by avoiding running on the toes – even when running up hills. Some people who know a bit about the Pose Method might be puzzled right now because they’ve heard that Pose Method runners run on their toes. That is not correct – we run on the balls of our feet and, to us, there is a big difference between running on the balls of the feet and running on the toes.
Note: At this point, some may want to debate the merits of the Pose Method, or ball-of-the-foot versus mid-foot versus heel-toe running. They may even want to debate what proper running technique is or should be. I’d rather not get into those debates right now – all I want to do today is describe the Pose Method approach for dealing with with Plantar Fasciitis.
Ok, let’s start with a video approximation of what is commonly known as “toe-off” or “push-off”:
And here is an approximation of what Pose Method runners aim to do – to very quickly lift the foot off straight up off the ground without bringing the toes into it. The strategy is to land with weight on the balls of the feet, and then quickly lift the foot, not place weight on the toes and avoid strain on the Plantar Fascia:
As you can see, the Pose Method solution is not to strengthen and stretch muscles – it is to avoid a style of running that involves “toe-off” / “push-off”.
One last point: Some forefoot/ball-of-the-foot runners may acquire Plantar Fasciitis not due to “toe-off” but instead due to a tendency to hold their heels too high off the ground when they land. The solution to this problem is to weight on the ball of the feet but to allow the heel to come close to (or even lightly touch) the ground. This is not to be confused with a heel-strike – it is not that – it is merely allowing the heel to come down so that strain is not placed on the Plantar Fascia.
Was this clearly explained? Do you have any questions? I’d be happy to help.