Vivian Grisogono

Plantar fasciitis

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Pain in the sole of the foot.
Q: My husband has a plantar fasciitis in one foot which is causing him to limp; as he is a keen runner (and we are both hoping to run the Great North Run later this year) he would particularly like it to improve.

A: Firstly, it's important to identify what caused the plantar fasciitis. This problem causes tightening in the soft tissues in the centre of the sole of the foot, when the foot is stretched as you push off the toes in walking or running. The cause can be complicated: for instance, it can be linked to hormonal factors, sometimes related to thyroid function. Especially if the cause is uncertain, it is advisable to have a specialist check the foot in order to establish an accurate diagnosis and appropriate treatment programme.

The most usual cause of plantar fasciitis is stiff soled shoes. A common problem in modern running shoes is a stiff heel section which extends too far forward into the midfoot area. So checking the shoes for flexibility by holding them and twisting them about is a must, and any shoes which are not pliable should be discarded.

There are some simple self-help measures which can alleviate plantar fasciitis, or even cure it.

An arch support, or preferably a soft insole with a raised arch support, helps to take the pressure off the plantar fascia. There are a lot of different types, which can be found on the internet, or in well-stocked chemists' or running shoe shops.

It's generally helpful to rub the sole of the foot over a golf ball or one of those wooden foot "massagers", as this eases the tight tissues and helps the circulation. This can be done when sitting down, and is especially useful for people who have to sit for long hours at work.

Massage with arnica or heparinoid cream can have beneficial effects, while warm baths are good for the circulation generally.

Foot exercises , done barefoot, will help to keep or restore function in the foot’s supporting muscles. It's also advisable to do leg exercises, to ensure all the muscle groups are working well, and that there isn't extra pressure on one side or the other, or one part of either leg. These exercises should work the muscles of the foot, calf, knee, thigh and hip. If there’s pain in the foot doing standing exercises, exercises should be done in the sitting or lying positions.

Obviously your husband should avoid running while the pain persists during walking and running. He can maintain aerobic fitness by using a rowing machine or exercise bicycle . Once there is no pain on walking, he can start to run again. Using a mini-trampoline just to get the feel of running can be a good way to start to re-build confidence. He must have flexible running shoes. Once he starts running normally, he should start with short distances, and only run once or twice a week, avoiding running on consecutive days.

Even when you are aiming for a particular event, it’s preferable to arrive at the starting line fit and healthy, rather than over-tired or injured through trying to make up for lost time in training. High-mileage training is risky at the best of times, and more so when a runner is coming back from an injury. Quality training with plenty of variety is a much safer way of regaining fitness.