Saturday, June 19, 2010

Plantar Fasciitis, Part 2

Simply put, plantar fasciitis is caused when you stress your plantar beyond its structural strength. This is basically true of all injuries. Nothing breaks – or begins to break, tear, etc. – until you stress beyond its structural integrity. When you demand more from tissues than they can withstand, they begin to fail.
Much stress is accumulative – tissues normally develop tiny micro-tears, which heal quickly. The healthier the athlete, and the better their diet, the faster they heal. Still, if you don’t allow normal micro-tears to heal before stressing again, micro-tears become bigger tears, which take longer to heal, and scar-tissue accumulates, which is almost permanent and can lead to other injuries.

PF Cause...
There are numerous ways to develop PF, but all instances are caused by exceeding the strength of the plantar attachment and/or demanding more than the plantar can sustain.
Extremely weak, sedentary, and over-weight individuals have extremely weak muscles (which doesn’t allow proper shock absorption), and bad walking form. They often walk straight-kneed, landing on their heels, inflicting direct trauma to the plantar attachment area. When walking, this heel trauma is followed by shifting the weight forward, yanking on a relaxed plantar, surrounded by weak muscles that are doing nothing to help.
At the other extreme, athletes may be trying to conserve energy by relaxing as much as possible – including their arches – causing some atrophy of the foot muscles.
Modern shoes do an amazing job of making running easier, allowing bad foot-form while running. Minimal footwear normally causes discomfort over time and forces runners to use foot muscles to produce all bounce and shock absorption, but soft, springy shoes lead to laziness.
Athletes who are most likely to develop PF tend to be heavier than average, older than average, run many more miles than average, or a combination of these factors. People who specialize in downhill running put far more stress on their plantar fascia than people who specialize in uphill running.
It’s not necessarily that an athlete’s foot muscles are “weak”, but they are not strong enough in proportion to what is demanded.
With the popularity of ultra-running, and consecutive hundred-mile-weeks, coupled with modern running shoes, PF is more common than ever, even for skinny teen athletes.

Common symptoms of PF sufferers are very tight calf muscles, weak shin muscles (imbalanced with calf), weak or insufficiently strong foot muscles. Many suffer from cramping calf muscles during the PF development stage.
Falling arches tend to cause your ankles to sag inward and your toes to point outward (duck-footed) even if the heels are still pointed straight. Sagging ankles lead to over-pronation. Over-pronation may lead to PF, or falling arches may lead to over-pronation. Either one may cause the other. Not all these symptoms are experienced by all PF sufferers – it depends on what type (cause) of PF they have.
If your plantar is too tight, your toes may point straight or inward, and you might suffer from under-pronation. Under-pronation may lead to PF, or tight arches may lead to under-pronation. Either one may cause the other.


In “Brain Training for Runners” by Matt Fitzgerald, Tim Noakes, they say over-striders try to land softly. “Unfortunately, the softer you land, the more “free” elastic energy you waste, because it dissipates before you can reuse it. You transform yourself into a loose spring.”
Free elastic energy is a quick process, like a pogo stick. If you were on a pogo stick, and you tried to use your legs to lengthen the amount of time on the ground, you’d see the wasted affect. You’d actually expend more energy to accomplish less.
Fitzgerald and Noakes call the proper use of free elastic energy “ballistic action”, which is short and fast. “Many distance runners believe that the ideal pattern of muscle action during running is sustained and gentle. The idea is to use energy evenly throughout the stride, landing softly, staying relaxed, and avoiding wasteful “peaks” and “valleys” in muscle work. In reality, the best runners have a ballistic style of running.”
The fact is, even distance runners who are well aware of these principles often fail to properly implement them. They get tired after long hours, or they don’t rest/sleep enough, or they have other foot issues that keep them from being able to fully implement ballistic action.

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