Plantar fasciitis and Steroid Injections

December 30, 2022

Most runners have experienced plantar fasciitis or know someone that has. One of the most common treatment choices for a quick fix is a corticosteroid injection. In my opinion, this is one of the worst things you can do. While the injection may give you immediate relief, it will most likely not last long. “There was significant decrease in pain and improvement of function in steroid group at two weeks and eight weeks follow up; whereas at 16weeks follow up plantar fascia stretching groups improved significantly.” (Gurung et al. 2021) Corticosteroid injections can also lead to serious complications. “As evidenced by Crawford and Gudeman, steroid therapy in plantar fasciitis plays a significant role in short-term therapy [20, 21]. However, a number of complications were noted including plantar fascial rupture, plantar fat pad atrophy, lateral plantar nerve injury secondary to injection, and calcaneal osteomyelitis.” (Tatli and Kapasi, 2009) In order to get long-lasting relief you must learn the appropriate exercises to stretch your calf and strengthen around the foot and ankle.

Plantar fasciitis is very common and one of the most dreaded injuries. Pain is typically located in the medial heel and a common symptom is pain first thing in the morning when taking your first step out of bed. Plantar fasciitis can linger for months and put a stop to running for some time. Your best course of action at the very first hint of symptoms is to start stretching your calf muscles. I also recommend a break from running but continued cardiovascular fitness by doing any other exercise that is pain-free. Most runners will be able to cycle or even use an elliptical machine without irritating symptoms.

If you do choose to keep running some tips to make it more comfortable are: massage the calf muscles and foot before you run, do the below stretches, stick to softer surfaces and reduce your speed and distance. You can also try over-the-counter arch supports or more stable running shoes and roll out your foot after running on a ball or frozen water bottle.

Two stretches to address the calf muscles are pictured below:

Gastrocnemius Stretch

Keeping your toes pointed forward and your back heel on the ground, lean into the wall without bending your back or your back knee. Hold the stretch for 30 seconds and repeat 2-3 times on both legs.

Soleus Stretch

Stand facing a wall as above. Move your back leg in closer to the forward foot. Keep your heels on the ground and bend both knees. You should feel this stretch closer to your heel. Hold 30 seconds and repeat 2-3 times on both legs.

References

Gurung, S., DC, G. S., & Pant, B. (2021). Stretching Exercise versus Local Corticosteroid Injection in Plantar Fasciitis: A Comparative Study. Journal of Nepalgunj Medical College, 19(2), 32–35. https://doi.org/10.3126/jngmc.v19i2.42861

Tatli, Y.Z., Kapasi, S. The real risks of steroid injection for plantar fasciitis, with a review of conservative therapies. Curr Rev Musculoskelet Med 2, 3–9 (2009). https://doi.org/10.1007/ s12178-008-9036-1