Plantar Fasciitis Concerns Cyclists Too!

While Plantar Fasciitis (PF) is more often associated with running it can also affect cyclists. Case in point, it's something I suffer from periodically and I can assure you running is nowhere in my past or future. Having mild PF currently, I've been doing some research and in recent weeks came across a number of sources with lots of potentially useful information. Thus, knowing that some of you may also suffer from this problem, I thought it might be helpful to summarize some of the potential solutions that are available. As you know from previous posts I'm not a medical doctor. The information given below is just that - a place to start your own research into this potentially uncomfortable problem.

Before we start discussing solutions, let's briefly discuss what is Plantar Fasciitis? PF is a painful inflammatory process of the plantar fascia, the connective tissue on the sole (bottom surface) of the foot. It is often caused by overuse resulting in microtears or contraction of the plantar fascia or arch tendon of the foot. This, in turn, may cause chronic bone traction in the heel and the formation of bone spurs. It is a very common condition and can be difficult to treat if not looked after properly. It has been reported that plantar fasciitis occurs in two million Americans a year and in 10 - 15% of the U.S. population over a lifetime. Years ago it was commonly referred to as "policeman's heel" but today it is a problem mostly associated with runners and those who are overweight. If not treated and allowed to worsen, PF can make walking extremely painful.

There are many potential ways to treat PF. The method, or more often combination of methods, you choose in consultation with your doctor will depend on the extent of your injury. Also, remember the old saying, "one man's meat is another man's poison". With PF, what may work for one person may not work for the next! In no particular order, PF treatment techniques include:

Stretching: Has been identified as one of the best, safest and most cost-effective conservative therapies for PF. This may involve stretching of the foot itself, or stretching the leg muscles that connect to the foot. The foot can be stretched in a variety of ways. Deep tissue massage with a hard ball (such as a tennis, lacrosse or golf ball) worked under the foot is particularly effective at stretching the tendons. Personally, I've found regular stretching of the calves and Achilles to be helpful in reducing PF discomfort. Keeping these muscles/tendons stretched reduces tension down the leg and consequently takes some of the pressure away from the plantar fascia. Some good lower leg stretches include hanging off a stair, pushing against a wall and sitting on the ground and using a towel around the ball of the foot. An excellent article on stretching can be found here. Further, use of a night splint, plantar fasciitis "boot" or Strassburg Sock can keep your tendon stretched while you sleep. These night solutions work by holding the foot at approximately a 90-degree angle to your shin, which keeps the fascia from contracting throughout the night.

Ice: Can be helpful for temporary relief. A frozen water bottle rolled under the arch of the foot is one method of applying the ice. Another technique is an ice massage. Fill a Styrofoam cup with water and freeze it. Once frozen peel back the edges of the cup and circle massage each foot for 10 - 20 minutes twice a day.

Nonsteroidal Anti-inflammatory Drugs (NSAIDS): NSAIDs, such as ibuprofen (Advil, Motrin, etc.) and naproxen (Aleve), may ease pain and inflammation although they won't treat the underlying problem.

Foot Strengthening Exercises: Many people report that the appropriate use of foot strengthening exercises can help significantly with the long-term reduction of PF. These exercises involve working out barefoot or using something like the Vibram Five Fingers shoe. You can also try picking up a pencil, marbles or a golf ball with your toes. Another exercise is to get on a step with your forefeet and go up and down, above and below the level of the step (also see stretching). Strengthening exercises are typically used in conjunction with looking at the improvement of your form.

Your Form: Whether you're talking about your pedaling, bike dismounting, walking or running form, the use of correct motion can greatly help with a current case of PF or reduce the likelihood of a new case.

Cross Training: One of the problems with cycling is that it doesn't give you a natural calf stretch and the tightening in your calves can aggravate your PF condition. Staying in shape with other forms of training can help rest a foot already suffering from PF. Be careful with swimming. While it's a great cardio exercise, the pointed-toe and kicking associated with the swimming stroke can again tighten your calf rather than providing you the natural stretch you need.

Wearing Good Shoes: Aside from using a good pair of cycling shoes (which have a stiff sole and therefore protect the arch), wear a good pair of general shoes (even indoors) whenever possible to help support the arch. Avoid walking barefoot or wearing shoes such as sandals or dress shoes. As I said earlier, "one man's meat is another man's poison".

Orthotic Devices: These can be very successful for some people. The orthotic typically provides additional support to the arch. In some cases, it may also act to relieve pressure on a certain part of the foot. Before buying custom orthotics, there are some very good off-the-shelf products you might try. Some people believe that while orthotics can stop the pain they make your foot weaker as the shoe (orthotic) does all the work. This can increase the chance of injury when you're not wearing the orthotic.

Weight Reduction: If you're overweight, losing weight will often help relieve PF symptoms. Many people report if they gain significant weight, PF can often result.

Time: Plantar Fasciitis can't generally be solved overnight. A severe case might take nine or more months to resolve. Further, after certain types of treatment sufficient time should be allowed for rest and healing. PF is slow to heal because the white tissues involved don't get much blood flow. Once the PF is resolved, cross training, strengthening and stretching will help prevent the PF coming back.

Take It Easy: Don't abuse yourself. Try and avoid the, "try as hard as you can" notion that permeates all sports. Resist pushing big gears, sprinting and charging up hills. These are all going to put extra stress on the foot.

Extracorporeal Shock Wave Therapy (ESWT): In this procedure, ultrasonic sound waves are directed at the area of heel pain to stimulate healing. It's usually used for chronic plantar fasciitis that hasn't responded to more conservative treatments. This treatment can be expensive and may not be covered by health insurance.

Cortisone Shot: This steroid shot can be effective and is often tried after other methods have failed. However, it only really treats the symptoms and not the cause. Relief may only be in the short to medium term as the effect wears off - additional treatments may be required. Some research has shown that these shots can cause tissue damage, as such too much-repeated use is not recommended.

PRP Shot: Many doctors have begun to use plantar fasciitis platelet injections to combat PF. In this therapy, platelets are concentrated from the patient's own blood to create platelet-rich plasma (PRP), which is then re-injected into the foot. Some doctors believe this treatment is more effective than Cortisone steroid shots as the effects last longer and there is a reduction in tissue damage.

Topaz Surgery: This minimally invasive surgical procedure usually takes about twenty minutes. This is classified as an aggressive treatment and is usually only considered when other methods have failed. Reported recovery rates are high (typically 95%), with mild pain and tenderness lasting anywhere from three days to a week.

Tags: Plantar Fasciitis, preventing foot injury, foot injury treatment, indoor cycling, cycling shoes, stretching.