Plantar Fasciitis

What do you know, I developed a case of plantar fasciitis from hiking. Now my heel hurts even when I climb. An osteopathic doctor prescribed physical therapy. It helps, but I still have the pain, and I am wondering if I can still hike and climb.

—Jack Glabe

Plantar fasciitis (PF) is a common foot ailment and likewise is the most poorly treated. PF is a strip of ligamentus tissue that connects the heel to the toes, and forms the arch of your foot. You can achieve PF by either an acute tear—say, from jumping down from a boulder—or chronic overload, for example from a new pair of shoes or pushing a mower all day when you’re unaccustomed to that activity.

Bear in mind that the catalyst that sustains Plantar Fasciitis can be a lot less than the one that got you there in the first instance. Though climbing will rarely be causative (the aggressive downturned arch in modern shoes being very protective), it is amply capable of maintaining it.

Pain usually occurs at the end of the arch under the heel, especially first thing in the morning. After you walk around for an hour, the pain may diminish significantly, often going away completely. You are stuck in a daily cycle of re-injury that starts when your feet hit the ground in the morning. When you sleep, your feet are pointed, allowing the load to come off the arch in your foot. The damaged tendon now tries to knit itself back to health, but after only seven or eight hours it is fragile, to say the least.

[Read More Articles About Climbing Injuries and Prevention Here!]

In an “Edge of Tomorrow” moment, the instant you stand up in the morning, you are jettisoned back to the day before, which would be more tolerable if you got to spend each day with Emily Blunt.

The daily cycle of re-injury must stop, and this does not require fancy socks or shoes with a rocker, nor do you need to strengthen your calves or drink more kombucha. No, getting better is simply a matter of not pissing it off every morning.

There is only one rule: When you get out of bed, do not put your feet on the ground unless they are in shoes with good arch support. This includes when you get up for a waz during the night.

Better still, when you wake and before getting out of bed, gently stretch your feet for five minutes using a towel around your toes. Gently! Even better, ask your partner to get you a rice bag heated up in a microwave to really warm up your feet. A warm ligament is more flexible and less likely to be re-injured when you start walking.

There can be some setup causes of Plantar Fasciitis: a badly rolled ankle last year, Achilles tendonosis, over training, arch problems, etc. These can cause chronic overload of the plantar fascia and need to be addressed. Sit on your foot and stretch it in every direction for 10 minutes. Tone down the training for a month and be careful of sudden loads, especially if you are not warmed up.

This article about Plantar Fasciitis appeared in Rock and Ice issue 262 (March 2020).