Orthopaedics

Overuse Injuries of Runners: Q&A with Dr. Paul Hecht

Overuse Injuries of Runners Home | Overuse injury of ligament: Plantar Fasciitis | Overuse injury of tendon: Achilles Tendinitis | Overuse injury of bone: Stress Fractures | Overuse injuries: A Recap


Overuse injury of ligament: Plantar Fasciitis

Q: Why does my foot or arch hurt?

A: It may be plantar fasciitis. The plantar fascia is a very thick band of tissue covering the bones on the bottom of the foot. Read more about the condition in DHMC’s Health Enyclopedia

The injury occurs from overuse of the ligament and is characterized by:

  • Pain you feel on your first step out of bed in the morning or after you have been at rest for 15 to 20 minutes
  • Sharp pain inside or at the center of the heel
  • Pain that may diminish as you walk but is present throughout the day

Questions to ask yourself include:

  • Have I increased the mileage I run recently?
  • Have I been running at greater intensity recently?

Q: I am not a runner but I think these symptoms describe what I am feeling. What are some other causes?

A: Other sports and even walking can trigger this condition. People who participate in jumping sports like volleyball and basketball also are at risk for such an injury.

Q: So what can I do to prevent plantar fasciitis or to ease the pain?

A: Dr. Hecht advises that you consider the following aspects of your running program:

  • Cut back to some degree.
  • Look into a stretching program. You can speak to a physical therapist or a doctor certified in sports medicine to learn how to correctly stretch your Achilles tendon and plantar fascia.
  • Make sure your running shoes are adequate. Are they well-cushioned? Do they fit properly? You may need an over-the-counter orthotic insert, although sometimes custom orthotics may be necessary. This means you can purchase a full-length replacement insole or try to find someone trained as an orthotist to make one for you. Here at DHMC, call Physical Therapy Services at (603) 650- 5978.

Q: I have tried stretching and cutting back on mileage and intensity of my running program. What now?

A: Almost no one needs surgery for this injury. If you have experienced persistent pain for several weeks after changing your behaviors, seek medical attention. Options at this point may include:

  • A course of physical therapy
  • A night splint or a resting splint
  • In "recalcitrant cases"—when your injury resists conventional treatment—you may require up to four weeks in a walking cast.