Plantar fasciitis

Whether you’re a weekend cyclist or a high-level athlete, injuries spare no one. They make us sad and grumpy and each deserves an explanatory sheet using the 5W1H method (Who, What, Where, When, Why, How). The idea behind this series of short articles is to better understand them, adopt the right behaviors to avoid them, and know what to do to recover better.

I propose to cover, each time, in the form of the “5W1H” (What, Who, Where, When, How, Why) and in as many articles as there are recurring injuries in cycling and triathlon, all possibilities of frustration related to forced rest.

After the knee, the clavicle, saddle sores, spinal pain, iliac artery endofibrosis, Achilles tendonitis, compartment syndrome, carpal tunnel syndrome, head trauma, digestive disorders and shin splints, today I offer you an explanatory sheet – always using the 5W1H approach – this time for plantar fasciitis, also known as plantar aponeurosis.

By Jean-François Tatard – Photos: Jean-François Tatard, Pxhere.com

WHAT?

Have you ever experienced pain under your heel? Because plantar fasciitis is the most common cause of pain in that area. It is an inflammatory tendonitis under the foot. It is more generally called plantar aponeurosis.

Mechanically, it resembles the work of a pulley. The plantar aponeurosis is a thick connective tissue that supports the arch on the plantar side of the foot. The aponeurosis plays a very important role here. It is what loads the gait cycle. It wraps around the calcaneus and extends towards the toes.

Plantar aponeurosis does not only affect runners.

When you ask an experienced runner what this kind of injury feels like, they report that the pain gives them the impression of standing on a pebble.

WHO?

Contrary to what we might believe, plantar fasciitis is not exclusive to runners. Up to 7% of the population suffers from this pathology. We often find runners, but not only… During lockdown, many people enjoyed jumping rope! Jumps or any activities involving a lot of jumping expose us to this pathology.

WHERE?

The pain is located under the heel or sometimes lower, in the arch of the foot.

WHEN?

You often feel a burning sensation under the heel or the arch of the foot, which is generally worse after a period of inactivity. This is especially noticeable in the morning after you’ve spent the night in bed. At first, the pain subsides after a few steps. And then it’s there more and more often. Standing all day is also a lead to explore if you’re trying to identify the causes.

Plantar aponeurosis can develop gradually.

HOW?

How was it caused? There are several possible risk factors. The cause can be biomechanical. Some people have flat feet while others have high arches. And depending on your foot profile, this can alter the load absorbed by the plantar fascia during weight-bearing in your running cycle. Also check your weight on the scale! Being overweight inevitably increases the load through the fascia. Overuse can also be a lead. A sudden increase in volume and intensity combined with poor lifestyle habits (insufficient rest, poor hydration, overly acidic diet) will also threaten this anatomical part. A word of advice: don’t delay! It sets in like a weed and is difficult to get rid of. So consult a specialist! They will give you a more in-depth diagnosis that will allow for the most appropriate management possible. Logically enough, plantar fasciitis will be treated holistically, as its appearance is often not attributable to one definitive thing.

The pain sets in like a weed and is difficult to get rid of.

But how do you get rid of it? First, it’s important to unload the fascia. A visit to a podiatrist can be considered. They will design custom orthotics for you. But before that, more simply, you may need to reduce your activity level for a while. We don’t like it! I know! But it’s to get back to it better later… There’s another simple thing to do, which I call the SPD (Subjective Perception of Pain). On a scale of 0 to 10, evaluate the pain level! Beyond 5, put on the handbrake! And if it increases during or after exercise, then definitely take matters into your own hands and consult without delay!

Some solutions: MTP (deep transverse massage by rolling a tennis ball under the foot) in combination with ice application for 10 minutes 3 times a day. And a “homemade” technique that will cost you 10 cents and allows you to do both at the same time: freeze a water bottle and roll it under the arch of your foot 3×5 min a day! It’s not necessarily the best miracle cure, but if the fasciitis isn’t too advanced yet, it works quite well. At a more advanced stage, something else that gives good results: an exercise that consists of a simple heel raise. To start, this can be done with both feet on the ground. Use a rolled towel to extend the toe upwards and stretch with an additional load at the fascia. You can progress the exercise by doing it on one leg, and finally by doing it over the edge of a step. Another detail for this to work, you must do it slowly: 3 sets of 10 or 15 once every two days (3 up, 3 down).

Use a rolled towel to extend the toe upwards and stretch with an additional load at the fascia.

And finally, if none of the physiotherapy techniques work: MTP, Cryo, cupping, dry needling, eccentric exercises, shockwaves, etc. – this was the subject of an article a few weeks ago – PRP may be considered. The results are often quite spectacular.

WHY?

In reality, we spoke of tendonitis or inflammation, but this is not necessarily true. Most often, it is a degeneration of the fascia. It is generally an overuse injury. It can be linked to generalized weakness. Or to a deconditioning of the ankle muscles compared to the lower limbs. Moreover, many cyclists are affected. What happens is that a cyclist’s musculature is often more imposing than that of a runner, and by default, the cyclist is weak in terms of the elasticity and length of their tendons. When given the opportunity to run, during the off-season, during winter preparation, or after their career, they do not necessarily realize their weaknesses. Their range of motion is notoriously reduced, especially at the ankle.

In short, you should always listen to your body and the warning signs that come with it!

CONCLUSION

This series of 12 sports pathologies, each with a 5W1H explanation, aimed to support you in managing your injury. To show you that there are always solutions and that it is important to keep hope. We also learn from our investigations. 10 of these 12 pathologies are problems I have personally experienced and systematically gotten rid of. And systematically, I have never encountered them again.