What’s That Pain in My Heel? The CrossFitter and Plantar Fasciitis

Ouch. You have this pain in your heel. It comes and goes, but it’s definitely worse when you first get up in the morning and step onto the floor. You’re not alone. Plantar Fasciitis (an overuse injury that affects the sole of your foot) is one of the most common injuries reported among CrossFitters. It’s not a result of CrossFit; blame our heel-striking society and the fact that, in the WOD, we tend to run.

So, what can you do? Treat your Plantar Fasciitis and then learn an alternative style of running, like POSE or Chi. In the meantime, you need to deal with the pain, so we bugged our resident physical therapist, Melissa Reed, for some information. As soon as she could break away from kicking everybody’s butt at “Fran”, she gave us these tips:

·         Perform a Great Toe Flexor Stretch every morning before you get out of bed and again later in the day. Basically, grab your heel with one hand and pull your big toe towards your shin with the other hand. Hold the stretch for 15 seconds, rest for 30 seconds. Do 4 repetitions.

·         Perform this stretch (Gastroc Stretch) and this one (PF Stretch) a couple times per day also.

·         Freeze a water bottle and place it on the floor. Roll the affected foot over the bottle for 5 minutes each day.

·         Wear a well-designed, supportive shoe. Don’t go barefoot, even in your house. Support the arch of your foot almost always.

·         And (you knew this was coming) see a professional. You might think it’s PF but it could be something else. And even if it is PF, your treatment may vary, depending on whether your PF is the result of a traumatic injury, your foot structure, scar tissue build-up, or simply the way that you roll your foot when you walk. Consequently, treatment could be deep massage, rest, orthotics, or even more involved procedures. Trying to diagnose the cause of your own pain is like trying to identify the main flaws of your Clean and Jerk without a coach or a video camera: you might get some of it right but you’re probably missing the big picture.

We tried what Melissa said and, wow, did we find some pain relief fast: the big toe stretch in the morning was particularly effective. Everything else she said seemed to help too. What else did we find that worked? Subbing rowing for the runs in the WOD, to provide some healing time. We also subbed some cycling when we could. When we did run (oh “Helen”, you temptress!) we tried to pay particular attention to proper foot striking.

Finally, we had to confront our love for the ultra-flat Chuck Taylors -– because they could have been exacerbating the PF. (Now, if we didn’t have this pain, the “lift barefoot or in Chucks” mentality that abounds in CrossFit might have prevailed but, quite simply, when something’s wrong, we need to fix it.) Ultimately, we loved our Chucks too much to give them up, so we relegated them to Max Effort and lifting-centric WODs. The rest of the time, you’ll find us in our squishy, well-supported, well-arched shoes. We may not look as cool but, boy, do our feet feel better.

(Text by Lisbeth Darsh/CrossFit Watertown in Connecticut.)

Comments

[Craig]

I had this BAD in my right foot - happened while doing 400m intervals.

Took 4wks to heal:
1. Some stretching
2. Icing as above
3. Insoles with arch support in all shoes.
4. Sleeping splint (HUGE help!)

PF is very painful when you wake in the morn (or get up in the middle of the night) because the tendon heals with your foot relaxed and extended. Sleeping with a brace helped immediately by holding the foot in a 90deg position, and allowing the area to heal in a normal position.

http://www.roadrunnersports.com/rrs/products/PRO012/

Reef thongs have great arch support and are excellent for around the house walking. Superfeet makes a great insert for all shoes.

[Jake]

Lisbeth, great article. I would like to add something if you don't mind.

Many times the PFitis is secondary to a subtalar restriction the medial glide of the calcaneus on the talus has been lost, resuling in greater strain on the PF.

A simple manipulation will relieve this, then following everything Melissa suggested you will be well on your way to being pain free, and wearing Frees, Chuck taylors, wrestling shoes, or my favorite barefoot.

Also movement prep/dynamic stretching is good to be done barefoot.

Thanks for all the work you put into these articles. It is much appreciated.

Jake Thompson MPT, ATC, CSCS, CF LI

[Lis]

Thanks for the added info and the tips, guys! Keep 'em coming!

[Donald]

Another good article. I was plagued with this affliction for years. I am a personal trainer with 7 years experience and even before I got into Crossfit training, plantar faciitis has haunted me. I've tried stretching , which helps only to a certain extent, orthotics which ran into the hundreds of dollars, rolling a golf ball at the edge of the heel on the calcaneous, painful cortisone shots. Well I've just about gave up hope with about everything. Then something that I have been doing for years with my clients, but never thought about doing myself. The Foam Roller!! It's no wonder how this piece of myofacial release hasn't been thought of in the medical community, and I'm talking about Podiatry. If you have ever foam rolled you know that the fascia that surrounds all of our muscle tissue get tight every time we ask it to act intensely, whether it be double unders or box jumps, burpees, whatever jumping exercise we do it goes through trauma. We are a big Kietic Chain and our muscles are connected from our toes all the way to our fingertips. What happens with Plantar Faciitis is that the our lower leg gastroc (calf) muscle or peroneals tighten up causing a muscle imbalance which may cause pulling on one side more than the other which translates to the foot and causes pain either on the medial or lateral side. Well this pull affects the plantar fascia which won't allow it to relax causing unbelievable discomfort even at rest. What I did was to get the roller and start rolling across the calf muscle and find the trigger point. A trigger point is a hyperactive muscle that does not relax and if stretched will irritate it more and will not let the muscle relax. This is where the old saying "no pain, no gain" really works. Lay on the trigger point moving very briefly over the site until you feel the pain lessen about 75% then move on and so on. The peroneals are located on the lateral side of the lower leg and they also should be rolled upon. I did this technique on myself over a weeks period and found that the plantar faciitis responded to this type of treatment successfully, at least for me and some of my clients who are afflicted with this dreaded syndrome. You have to be diligent and don't give up. But don't give up on the other techniques which will compliment this as well i.e. heel stretch, calf stretch, Golf ball and fascia massage. Good luck and I hope this information helps and provides quick relief to those of you who are afflicted with this pain in the ass condition.
Stay Healthy.

[Fred S-Foot Care Specialist]

Plantar Fasciitis is often caused by abnormal pronation of the foot and improper arch support. Contributing factors are weight gain, intense physical activity, jobs that require a lot of walking or standing on hard surfaces, or shoes with poor arch support.

Research has found that a combination of proper exercises and arch support by wearing orthotic insoles can provide effective relief for plantar fasciitis.

You can find more information on plantar fasciitis at http://www.footminders.com.

[Dougal]

I'd like to backup Donald's comment. The bottom of both feet felt bruised every day for months. After trying various things, I ended up with a massage. After 4 sessions, the therapist could differentiate the muscles. After another 3, the pain was gone. My calves still tighten up and need treatment but this was a world of relief.