You remember the commercial:

‘The best part of waking up… is Folgers in your cup.’

Debatable.

I’ll tell you what the worst part of waking up is though: Waking up with plantar fasciitis.

Those first few steps out of bed are agony.  Like you are stepping on tacks.  Or glass.  Or hot coals.

That pain isn’t limited to the first steps out of bed either.  When you have plantar fasciitis the first few steps after any extended period of time spent off your feet are pure agony.  Let’s have a look at what’s going on.

What is the plantar fascia?

A sheet of connective tissue that runs from heel to just shy of your toes.  Think of your arch as a bow.  The PF is the bow string.

What is plantar fasciitis?

PF is a condition that accounts for roughly 10% of all running injuries.  And since all runners are basically just biding time between injuries chances are you’ll eventually wake up one morning and feel like you’re walking on broken glass for about 10 steps.

From wikipedia:  Plantar fasciitis is a disorder of the insertion site of the ligament on the bone characterized by micro tears, breakdown of collagen, and scarring.

In plain English: You’ve been running a lot lately and your heel hurts like holy hell for the first 10-20 steps in the morning.

Is this you?  Sounds like you’ve got PF.

PF isn’t inflammation of the fascia but rather necrosis (tissue death).  This is caused because…

  • your foot is too flexible and the PF gets overstretched.
  • your foot is too rigid and the PF absorbs too much bodyweight too soon.  Remember that runners land with forces off up to 6 times their bodyweight.  (It’s a wonder we can run at all.)
  • you have bone spurs.
  • you have tight calves.
  • Lots of time on your feet.
  • Being overweight.

Have I ever had plantar fasciitis?

As a matter of fact I did.

I had plantar fasciitis for 3 straight summers.  It would bug me from around June until September, and then mysteriously disappear by October.  After 3 summers or waking up with intense foot pain I asked myself what was it that I was doing differently in the summer.

  • Was it the heat?
  • Was it more miles or time spent on my feet?
  • Was I wearing something during the summer that I didn’t wear in the fall?
  • Was there a moment where I injured my feet?

The good news was that the pain was in both feet which means the pain wasn’t the result of an accident or a single traumatic event.

Running injury rule of thumb:  Pain in two legs= good.  Pain in one leg= see your Doctor.

When both feet hurt equally you can breath easy.  You probably don’t need to see the Doc, just make one or two small changes and you’re good to go.

The fact that it came and went with the season suggested there was something I was doing during that time.

Like wearing sandals.

During the summer I wore sandals everywhere.  I began wearing them in June, put them away in late September.  The dates matched up with my foot pain.  I ditched the sandals (Never again!) and I have not had plantar fasciitis since.  Problem solved.

What about wearing sandals caused Plantar Fasciitis?

My theory, and I’m not a doctor, is that to keep the sandals on my feet I was curling my toes into the forefoot.  My arch was always flexed.  The fascia was under too much strain.

Hopefully we just figured out what is going on with your foot.  You just ditched an old pair of heels or a crummy pair of sandals.  Give it a few weeks.

But if you’re still in pain let’s look at three more things you can do to alleviate ‘the worst part of waking up’ and keep you moving.

Remember- I am not a doctor.  I’m just a guy who’s had every running injury ever (sometimes more than once) and I’m here to share some things that didn’t necessarily fix me, but allowed me to at least keep moving.

What I share below may fix you (no promises), but none of it will make you worse.

The best fix for any injury:  R.I.C.E.  Rest.  Ice. Compression.  Elevation.  It ain’t sexy, but start with that link.

Then…

1- Get 2 or 3 golf balls- STAT!

The first thing to do when you come up against plantar fasciitis is to grab a few golf balls.

Now take one of them and put it next to your bed.

Take another and put it next to your desk at work.

Carry a third one in your purse or your backpack.

(If golf balls are too hard you can use tennis balls instead).

Your  PF usually bitches at you when you stand after having been off your feet for a while.

So let’s skip the painful steps and warm up/knead out that PF before we put any weight on the feet and get that stabbing pain sensation.

Roll the golf ball under your foot and stimulate that tissue.  Wake it up.

I’m not going to lie to you- it’s gonna hurt a bit; but nowhere near as much as those first few steps in the AM.

Why does this work?

I used to tell people that the golf ball was grinding up the scar tissue.  If that analogy works for you- cool. Keep on thinking that.  Realistically your stimulating blood flow to the affected area and are waking up the tissue around the fascia.

If you don’t feel better after doing this you may try freezing the golf ball before (cold massage).

2- Voodoo floss Baby!

Let’s stimulate some blood flow into the affected area.

Wrap your affected foot in voodoo floss, create a tourniquet, move the fascia through the tourniquet, peel  off the wrap and voila.  Instant relief.

How does voodoo floss work?

Simple.  Voodoo.  Shamans.  Hexes.

Seriously though… I did an entire blog on this.  You can find it HERE.

Here’s a short video on how to floss the plantar fascia.  Enjoy:

The bad news: Every time I’ve used voodoo floss on a chronically injured person it works GREAT in the moment.  Pain goes away, rang of motion increases and people give me a ‘WOW!’ look.

Fast forward to our next appointment; I’m ready to re-apply the voodoo and their hands go up.

‘Hey, that stuff felt great in the moment, but…

‘when I got home…’ or

‘the next morning…’

‘There was pain.  Let’s hold off.’

If the injury is somewhat new I’ve never had a problem using voodoo floss.  But chronic sufferers often have an averse reaction to the voodoo later on.

3- Warm up your feet and your calves

First things first: when I say warm up I DO NOT mean stretch.

From NSCA.com:

‘Although well-designed warm-up procedures can enhance athletic performance, reduce the risk of injury, and lessen the potential for muscle soreness after exercise (1,21,26), it is important to realize that warming up and stretching are two different activities. A warm-up consists of preparatory activities and functionally based movements that are specifically designed to prepare the body for exercise or sport. In contrast, the primary goal of stretching is to enhance flexibility.’

Running injury rule of thumb: Warm up your muscles, don’t stretch them.

Stretching before your muscles are warmed up can be harmful.  So move before, and stretch after you have a sweat going or have run a mile or two.

How many times have I come across clients/runners who ‘stretch first thing in the morning’?  This is bad.  Why?  Because in the morning your muscles are cold and brittle, like a chocolate bar you’ve kept in the fridge.  If you try to stretch it will snap.  Like in the commercials:

But if you leave that candy bar out in the sun, in the heat, it will warm up, get pliable and move fluidly.  Like in the commercials.

So warm up- then stretch.

Warming up can be walking, jogging, yoga, foam rolling.  A good warm up will “increase blood flow to active muscles, raising core body temperature, enhancing metabolic reactions, and improving joint range of motion. These effects can boost athletic performance by enhancing oxygen delivery, increasing the speed of nerve-impulse transmissions, improving rate of force development, and maximizing strength and power.”

In plain English: a good warm up makes your muscles like warm Lava cake.  Or at least a gooey candy bar (No gifs for that- believe me I checked).

What constitutes a warm up to help with plantar fasciitis?  I’m sensing a rant coming…

Start Rant.

We take our feet for granted.  We stand on our feet.  We run on our feet.  We shove them into sneakers, heels, sandals.

Do we ever warm them up?

One of the things I’ve learned about running injuries is that tension/pain refer out.  The pain is a symptom of something being tight or weak somewhere (usually 1 joint) higher or lower in the kinetic chain.

Running injury rule of thumb:  Tension/pain/dysfunction refer out.

For runners the problem usually lies lower.  In the feet.  The most violent thing runners do day in and day out is run.  Think about it- you’re smashing down onto your feet at several times your body weight for thousands of steps.

End rant.

But Running Man, you say, how do I warm up my feet?

Well I just so happen to have collected a few of the foot and ankle stretches that have helped me greatly over the years.  Give this video a watch.  Then try each of the drills for a week or two.  If you find your pain has abated or improved then incorporate parts of or all of this into your warm up.

With warm ups we’re searching for the minimal effective dose.  You don’t need to warm up for hours or even minutes.  No need to do every drill in the video every day (though it wouldn’t hurt).  Find the drills that warm you up best, do them and move on.

Warm ups should extend to your calves.  This DOES NOT mean immediately stretching your calves.

Remember- cold candy bars.

Foam rolling is something you can do to cold muscles.  So let’s roll out the calves.  Try this:

and this:

One more thing: your plantar fascia didn’t go from being pain free to hurting overnight.  It won’t fix itself overnight either.

And finally lets try a dynamic warm up.  Some easy drills and movements you can do to warm up the calves.

Exxagerated heel to toe walks

Inchworms

So now that you have a long list of warm up movements try some out.  Note which ones allow you to run best and then repeat, repeat, repeat.  Do these drills until you have affected a change in your body and you no longer halve to.

Running Injury Rule of thumb: While some pain can be ‘fixed’ at the speed of the nervous system most recovery takes longer.  You are what you consistently do.

So take care of yourself.  Consistently.  Warm up.  Roll out.  Floss.  Mobilize.  and finally, at the end… stretch.  Streamline your routine.  Notice what works.  Repeat it, not just for a day but for weeks.  A friend of mine gave me a great quote about the human body:

‘Amazing design, but should come with a thirty year warranty.’

You have an amazing machine at your disposal but it is prone to break down.  Warming up is the cost to extend your warranty.