How To Gather A Crowd Without Stripping Naked

How To Gather A Crowd Without Stripping Naked

Plantar Fasciitis:  One Of The Most Common Running Problems

by Dr. Jay C. Goldstein



If you want to gather a small crowd at a social party of runners, just say the words “plantar fasciitis” in a slightly loud voice. 

Then wait for people to run (okay, limp) in your direction.  Most people know at least someone with plantar fasciitis.  Heck, most people have or have had plantar fasciitis (or fear getting it).



The plantar fascia is a layer of connective tissue that consists of three adjacent sections at the bottom and bottom-inside portion of the foot. 

The middle section is the thickest and strongest.  It extends from the bottom of the heel to the base of the toes, especially to the base of the great toe.  It plays an important part in the proper function of the foot. 

The structure can become inflamed (or even torn), creating the condition known as plantar fasciitis.



Here is my personal list of the top ten causes of plantar fasciitis:

  1. Crappy shoes.
  2. Excess weight.
  3. High force activities such as jumping.
  4. Extended activities without adequate training, such as running farther than usual.
  5. Lifting heavy objects.
  6. Applying force to the ball of the foot, such as standing on a ladder.
  7. Running faster without adequate training.
  8. Running downhill.
  9. Running on uneven terrain.
  10. Overstretching the foot/calf.



Symptoms range from a dull or deep ache to a burning sensation.  They are located at the bottom or periphery of the heel, and/or in the mid arch region of the foot.  Arch symptoms are usually along the inside of the arch but less frequently may be more toward the central or outer portion of the mid arch.

If only medicine was that easy!  Alas, if the cause was always plantar fasciitis, why would we have needed Dr. House for eight years?

Some of the other causes of similar symptoms include tendinitis, fractures and stress fractures, tumors, and bruising of the soft tissue and/or bone.



I have used at least 18 different treatments for plantar fasciitis.  The most common during the past year:

  1.  More appropriate shoes.
  2.  Custom orthotic devices.
  3.  Massage.
  4.  Electromagnetic therapy.
  5.  Injections
  6.  Better training techniques.
  7.  Altering various activities that apply more tension to the plantar fascia



Depending upon the nature of the injury, most cases of plantar fasciitis could achieve over 90% healing within 10 weeks.  For many of us, running is a significant part of our lives; ten weeks off sounds quite unpleasant. 

However, I have had patients who have suffered with plantar fasciitis for several years.  They would be quite happy to settle for ten weeks to heal.

Why so long?  I left out two important pieces of the puzzle.  Ten weeks for most of the tissue to heal is based upon:

  1.  Proper treatment.
  2. Total protection of the injured structure.



Proper treatment suggests that not every treatment on the Internet is appropriate for every case.  Some Internet suggested treatments are harmful.

However, total protection of the injured structure is the bane of treatment.

Would your mother have been satisfied if you got a “95” on every test you ever took?  (Okay, not my mother, but most mothers would be.)  In this case, Mother Nature is more demanding.

Instead of an injury to the plantar fascia, imagine a broken bone (heaven forbid!).  What if you protect the broken bone “95%” of the time?  The result would be that you only step on that break about 500 times a day.  Then you complain to your doctor about why it is taking so long for it to heal.



Every time that you take a step, you are applying enormous force to your plantar fascia. 

Multiply your body weight by 2, or 3, or 500, or more; a pretty large number, eh?  Those new fibers cannot hold up to that much tension.  In a very short time those new fibers are—poof—gone.  Bummer!

The lack of total protection of the plantar fascia during the healing phase is probably the most important reason why healing is delayed.  Now you know why Mother Nature is not satisfied with a “95.”

Plantar fasciitis or stripping naked?  Your choice.


Dr. Goldstein is a podiatrist who is Board certified by the American College of Foot and Ankle Surgeons, the American Board of Podiatric Medicine, and the American Society of Podiatric Surgeons.  He is a member of the American Podiatric Medical Association and the American Society of Podiatric Sports Medicine.  He has run about 33 marathons; if his brain had not bounced up and down so much he could probably remember exactly how many.



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