One of the biggest roadblocks to proper speed development is an injury. Athletes need to stay healthy (and happy) in order to progress towards faster times and better outcomes in their sport. Over 50 percent of athletes report playing a sport while injured,1 and a common nagging injury that athletes deal with is plantar fasciitis. This pain in the foot needs a better solution than what we now have because over a million patient visits each year are due to plantar fasciitis.2 An athlete can’t afford to lose precious training and playing time to this issue for which, I believe, we consistently look for answers in the wrong places.One of the biggest roadblocks to proper speed development is an injury, says @TomBroback. Click To Tweet
As with many injuries, plantar fasciitis is a condition caused by great amounts of stress repeatedly applied to an area of the athlete’s body, leading to breakdown, dysfunction, and pain. This is medically referred to as Davis’s law, and has many practical applications for helping athletes rehab from nagging injuries. Using an external device like an orthotic or a different shoe is a temporary solution to this issue, as it addresses symptoms (i.e., pain) but not always the underlying cause of the issue. For so long, we have looked to external support to help reduce the pain and frustration of plantar fasciitis.
If an athlete uses this solution, however, they are forever going to be dependent on that external device to alleviate the overwhelming stress on their feet. As a therapist who helps patients understand and value physical freedom, this seems like a terrible route to ponder as the primary solution.
A Prescription with No Expiration
A new wave of understanding is sweeping over health and fitness regarding the importance of foot strength and the connection between the foot and the rest of the body. I find it incredibly important that we apply these principles to athletes in pain because of how highly they need to value their physical health and longevity. The human body was designed to be robust and meet the demands of our lifestyles and perform all kinds of actions, from walking to running to jumping. Searching for external means of support as a long-term solution is, in my opinion, detrimental not only to performance but to health as well.Searching for external means of support as a long-term solution is, in my opinion, detrimental not only to performance but to health as well, says @TomBroback. Click To Tweet
One of the largest concerns from a physical therapist’s perspective is the chronic use of orthotics. You would never prescribe someone to use crutches for the rest of their life, or a walking boot, or an arm sling. Yet the healthcare system at large neglects to implement an expiration date for these devices. Using orthotics is a poor temporary solution for a much larger problem that is exacerbated by prolonged use and underutilization of more active treatment techniques like improving strength, mobility, balance, and coordination.
Shoes for the Sport
The nature of athletic footwear is another reason that orthotics cannot be valued as the only solution to address plantar fasciitis. It is during athletic events that we want an athlete to be at their very best—trying to cram an orthotic into a soccer cleat, a basketball shoe, or track spikes is a terrible idea. Have you ever tried this? This can restrict the freedom of movement that the 33 joints of each foot require for optimal performance.
The availability of sport-specific footwear is currently limited for athletes. While there are plenty of colors, patterns, and sizes to choose from, the functional design of many cleats and sneakers is constrained. While the barefoot, foot-shaped shoe wave has had a dramatic impact on the running community, it has yet to make a dent in sports like soccer, basketball, and football. Flip your shoe upside down and put it underneath your foot. Does it look like there is enough room for your whole foot?
Due to this limitation, it is imperative that athletes take care of their feet outside of their sport, as they cannot currently alter the footwear required by their sport. In order to prepare for the stress and demands of running, cutting, and jumping, an athlete’s foot needs to be strong, mobile, and adaptable to imposed demands. We are not going to get this through having a lazy foot that is stuck in a shoe with a clunky orthotic all day; but we can through proper strengthening, balancing, and by allowing the foot freedom to act like a foot.It is imperative that athletes take care of their feet outside of their sport, as they cannot currently alter the footwear required by their sport, says @TomBroback. Click To Tweet
3 Drills, 5 Minutes, Endless Results
Every coach has constant competing demands for time. While I don’t think you need to overhaul your entire practice or workout to address some of the limiting factors in foot health, I do think dedicating five minutes per day to a few of the below exercises can be a game changer. They enable athletes to stay healthy and to avoid resorting to external means of support and structure for their feet.
Lacrosse Ball Rollout
Have your athletes roll their foot on a lacrosse ball for one minute on each side. They should be able to put a good portion of their body weight into the ball to get the full effect. While this works on the mobility of the foot joints, it also gives the athletes time out of their shoes. The more an athlete completes this drill, the more they will appreciate the time to work on foot mobility. Every person appreciates the feeling of kicking their shoes off at the end of the day. Make this happen at every practice.
Coaches are great at encouraging work on the full range of motion for joints like the hip and knee, but not always with the toes. Taking time to bring each toe into full flexion and extension will allow athletes to keep this necessary motion to walk, run, jump, and perform at their best. This drill should take 20–30 seconds for each foot.
Single Leg Balance
Single leg balance is critical for athletes, as many sporting movements are completed on one foot. This can be done on a balance beam, a 2×4, or even the ground, and will allow each athlete to connect their sensory and motor receptors to their brain to improve their proprioception. In other words, athletes will understand how their body moves in space. One minute of balance work for each side. This drill can be progressed by closing the eyes, working on head turns, or playing catch with a partner.
Altogether, that is five minutes of work where an athlete can prioritize foot strength, health, balance, and freedom. This can be included in the warm-up or at home for extra work. As Eric Cressey always says, small hinges swing big doors.
Optimal Foot Performance
In his book Anatomy For Runners, sports physiologist and biomechanics expert Jay Dicharry notes that the big toe provides 85% of the primary support.3 When this relationship between the ground and the big toe is skewed, it can lead to lower extremity problems like plantar fasciitis. We can best minimize this by altering our footwear and going barefoot as often as possible at home. The last time we want our stability to be affected is during competition. Although it comprises a small portion of our day, it is vital that our feet can perform as optimally as possible during this time.The last time we want our stability to be affected is during competition, says @TomBroback. Click To Tweet
Dicharry also notes there is ample research showing that assigning footwear based on foot type does not have an impact on performance or injury.4 Are we trying to make a simple solution complex? Does it make more sense to do less with our shoes and orthotics and more with our feet? I think so. And it seems the research is pointing us in that direction. None of us have all the answers, but new research is helping us get closer to optimal health, speed, and performance.
There are still many great questions and unknowns out there when it comes to acute and chronic foot pain. Although frustrating at times, it makes sports medicine an absolutely fantastic field to be a part of. Different sports will have different demands for the role of a shoe and foot. One size won’t fit all (no pun intended). What matters most is what you are doing with your feet most of the time. Keep that in mind as we work to eliminate athlete’s foot pain in order to run faster, jump higher, and perform better.
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1. SafeKids Worldwide. Changing the Culture of Youth Sports Report. SafeKids.org. Published August 2014.
2. Buchanan, B.K. and Kushner, D. “Plantar Fasciitis.” In: StatPearls [Internet]. StatPearls Publishing; 2020.
3. Dicharry, Jay. Anatomy for Runners: Unlocking Your Athletic Potential for Health, Speed, and Injury Prevention. Skyhorse Publishing; 2012.
4. Dicharry, Jay. Anatomy for Runners: Unlocking Your Athletic Potential for Health, Speed, and Injury Prevention. Skyhorse Publishing; 2012.