By Bobby DeMuro

Where is the plantar tendon and what purpose does it serve?
The plantar tendon runs the length of the bottom of the foot, spanning from the base of the toes to the front of the heel. If you think of the arch of your foot as a bow, imagine the tendon as the string. The two ends of the bowstring attach at the base of the toes and at the front of the heel bone by means of fascia, a fibrous membrane.

The plantar tendon keeps the arch of the foot from flattening completely when the foot is bearing weight, thus providing cushioning and shock absorption when you’re walking, running or standing; the tendon also allows you to point your toes.

What is plantar fasciitis and what causes it?
Plantar fasciitis is an inflammation of the plantar fascia, that connects the plantar tendon to either the heel bone or to the base of the toes. It can be caused by any motion of your legs that creates a pull on the plantar tendon. That means walking or running up or down hills, climbing stairs, walking or running on your toes, wearing high heels, and more.

It can also be caused by heel striking, usually a result of over-striding by runners. If you’re landing forward with each stride, you’re very likely to land on your heel. Landing this way can create a force on your heels of up to 6 times your body weight with each step, in a very small area to be absorbing so much pressure.

Another way that runners end up with plantar fasciitis is musculoskeletal in origin. On the back side of your heel is the attachment of the Achilles tendon, which runs up your calf. If your calves are tight, or your achilles tendon is significantly inflexible, you will pull and tighten the plantar tendon and weakening the attachment of the fascia to the bone as you walk.

If for some reason the plantar tendon is pulled beyond what the fascia is capable of holding, the fascia forms micro-tears and begins to pull away from the bone. This will cause the fascia to become inflamed.

If the plantar tendon is consistently over-stretched for weeks or months, the body begins to add calcium at the location of the attachment between the tendon and the heel. Over time, enough calcium is added to actually build more bone mass in that particular spot on the heel, and you end up with a heel spur, which is more serious than plantar fasciitis, and sometimes requires surgery.

Other causes of plantar fasciitis can include:

• Inflexible, worn out shoes, or shoes that bend in the middle instead of the ball of the foot.
• Low arches, or coincidentally, high arches
• Being overweight
• Spending long hours on your feet
• Tight calf muscles or tight and stiff ankle ligaments
• Walking barefoot in soft sand for long distances

What are some ways to prevent plantar fasciitis?
Learn to relax your lower legs, especially your ankles and calves, whenever you’re walking, running, sitting or standing. Tension held anywhere in your legs or glutes will pull on the plantar tendon when you move. As you run, always keep your entire lower portion of the leg as limp and relaxed as possible through every phase of every stride.

If you’re a runner, you should also be mindful of landing with a midfoot strike. If you’re a walker you should land on the front of your heel and roll forward onto the balls of your feet. Never strike on the back of your heels when walking. Make sure you have a straight posture line and that your pelvis is level and that you are landing with your foot directly under your center of mass.

Don’t reach forward with your legs when walking or running. Let your upper body lead and let your legs follow. This will help you maintain more of a midfoot strike and avoid all that pounding to your heel, which is one of the biggest culprits in plantar fasciitis.

Additional tips to consider:

• Shorten your stride length when walking or running.
• Walk and run on flat surfaces as much as possible.
• Avoid hills, trails and uneven surfaces when running and walking
• Avoid stairs if in discomfort; treat yourself to an elevator occasionally!
• Improve the flexibility of the calf muscles and achilles tendon which pull on the plantar tendon
• Get a foot massages. The deeper, the better!

Treatment if you are in acute pain:

• Soak your heel in a bowl of ice water (5-10 minutes) twice daily until the pain subsides.
• Scrunch towels or pick up marbles with your toes.
• Take Ibuprofen for treating inflammation, but avoiding dependence after several days.
• Walk barefoot across a coarse gravel surface. If the idea makes you wince, do it in socks. This will vastly accelerate the healing process, as it keeps the plantar tendon supple.
• Orthotics can help reduce the pain on the bottom of the heel, but be mindful that they will not fix the reason why you have plantar fasciitis. If you don’t want to be tied to orthotics for months or years, you’ll need to change the movement habits that are causing the problem.

All of this hopefully will set you on your way to preventing plantar fasciitis or gradually ridding yourself of this very common, and very annoying problem. Rest is your friend when dealing with plantar fasciitis, but understand that it is liable to come back if you fail to strengthen the area after the point of the initial injury.

According to an interesting New York Times health section article from 2009, the human body is built for distance. Part of the discussion includes the theory that humans are unique among animals in our distance-running abilities. The New York Times looked into the fact that we might just be the fastest, and best-equipped, of earth’s land-based creatures over the long haul. Some of our advantages include our foot structure, spring-like connective tissue, our cooling system, our glycogen storage capacity, and even our sense of balance over time.

Of further interest is the discussion on running injuries and footwear. Christopher McDougal, the author of Born to Run, suggests in the NYT article that many of our ancestors as well as some of our less-advanced contemporaries ran and do run many more miles with far fewer injuries than we do with our fancy modern running shoes.

The idea that primitive running is better running has been suggested before by proponents of barefoot running, alleging it actually decreases injury. It’s also the driving idea behind shoes such as the Nike Free and Vibram Five-Fingers.  And here’s food for thought with runners today: over 90 percent of runners training for a marathon experience injury according to statistics in the article.

When you start to think about it, though, the contention that running shoes (in part) are actually making us worse runners should kind of make sense. Think about it this way: Nike started business in the late 1970s. Meanwhile, humans were running around a lot of centuries before that, their feet shod in some very minimal items.

Yes, those humans most assuredly got injured, but they had to run – thousands of years ago, they had to run at some point for survival, and did so (or else we wouldn’t be here) without injury or massive problems. And yet today, with all of our technology, science, and knowledge (not to mention these high-quality running shoes), 90% of marathon runners get injured training for something that they attempt  in their leisure time? As our running shoes evolve are the wearers actually devolving?

Unfortunately, we can’t really answer the question. After going back and forth on the issue, from what we’ve seen with clients and friends, the issue of high-tech running shoes vs. low-tech running shoes vs. barefoot running is a very personal preference and matter. What works miracles for one runner may wreak havoc on another. It can be a maddening process trying to find the ideal way to address your feet, and experimentation to too great a degree can be costly in terms of injury and discomfort, in its own right.

How do you prefer to run? Are you brave enough (smart enough? stupid enough?) to run barefoot? Do you prefer the latest, highest-tech pair of running shoes? What are your thoughts?

After you’ve been running for a while, and you’ve maybe done a 5K or half marathon, you may start to focus on a new goal – running faster. If you’re fairly new to running, and you’ve never tried speed training before, there are some simple things you can do to start running faster. Or, if you’ve hit a plateau, and you’re looking to break through on your mileage times, you can do so when keeping in mind these seven different tips!

Be Prepared for a Little Discomfort
Some beginners have difficulty running faster because they’re afraid of feeling uncomfortable. But one of the first steps to getting faster is to learn what it feels like to pick up the pace. When you’re pushing yourself during speed training, expect to get out of breath and feel your leg muscles burning. That’s a good thing!

Now, achy joints, a stiff back, or knee pain are signs that you are pushing too hard – but muscle soreness and an elevated heart rate are part of the challenge if you are trying to improve your pace. Listen to your body, but don’t be afraid to push it!

Increase Your Stride Rate – not Length
If you can increase your stride turnover, you’ll run faster. The more steps you take, and the quicker you take them, means the more ground you are apt to cover. Increasing your stride simply puts your legs at an unnatural position, rather than speeding you up in any significant way.

Start by running at about your 5K pace for 30 seconds and counting every time your right foot hits the ground. Then, jog for a minute to recover, and run for 30 seconds again, this time trying to increase the count by one. Repeat this several times, and try to add another step each time.

Use Interval Workouts
Interval workouts are a fun way to work on your speed. You can do track workouts, such as 400m (one lap around the track) repeat runs. After a 5- to 10-minute warm-up, alternate between running one 400m at your 5K pace and jogging one slow, easy recovery lap.

Start with two or three 400m repeats (with a recovery lap in between each), and try to work your way up to five or six. Or, if you’re running on the road instead of a track, you can use lamp posts or telephone poles to mark your intervals. After warming-up, try sprinting for two lamp posts, then recover for two more. Keep repeating the pattern until you’ve covered a mile.

Do a Tempo Run Once a Week
Tempo runs help you develop your anaerobic threshold, which is critical for running faster. To do a tempo run, start your run with 5 to 10 minutes of easy running, then continue with 15 to 20 minutes of running near your event-day pace.

Finish with 5 to 10 minutes of cooling down. If you’re not sure what your event-day pace should feel like, run at a pace that feels “comfortably hard” – like you are competing against others and pushing a little bit quicker than on any normal day.

Try Hill Training
Hill sprints (or jogs) are an efficient way to build running strength. Find a fairly steep hill that’s about 100 meters long. Run hard to the top of the hill, and slowly jog back down. Start with 3 to 4 repeats once a week, and gradually work your way up to 6 to 7 of them, with as little rest in between as possible.

Lose Weight
If you’re already trying to shed some pounds, here’s more incentive: Research has shown that, on average, runners get two seconds per mile faster for every pound they lose. So, for example, a 10-pound weight loss would shave almost one full minute off your 5K race time!

Don’t Forget About Rest Days
Don’t assume that running hard every day will make you faster. Rest is critical to your recovery and injury prevention efforts, so don’t forget to take at least one day off completely each week.

Your muscles actually build and repair themselves during your rest days, and break down on the days that you exercise. So, if you run every day without taking days off, you won’t see much improvement, thereby setting up the stage for a plateau effect.

A valid connection between hypoglycemia, fatigue and termination of exercise is firmly established, and carbohydrate loading is a proven form of boosting endurance in prolonged events lasting more than two hours in duration. While there are various methods of carbo-loading, the process basically involves consuming large quantities of carbohydrate-rich food in order to saturate the body’s carbohydrate stores.

It is proposed that with these increased energy stores, the competitor will be able to avoid exercise-induced hypoglycemia and continue exercising longer than if this saturation process had not occurred.

The body stores carbohydrates for use in the liver and muscles in the form of glycogen. This carbohydrate store is basically human “starch” and is able to break down to fuel the muscles during high intensity exercise, and maintain blood glucose levels. In the non-carbohydrate saturated state, an untrained individual consuming an average diet is able to store 100 grams of glycogen in the liver, whereas muscle is able to store about 280 grams.

Muscle glycogen is committed to be used by muscle and cannot assist in maintaining blood sugar. Therefore should no additional carbohydrate be ingested during prolonged exercise, the task of maintaining blood glucose levels rests firmly on the liver’s glycogen stores. Even with full glycogen stores, a less conditioned athlete’s liver will be depleted of carbohydrate within 100 minutes of continuous moderate intensity exercise.

Once liver glycogen levels begin to drop, and exercise continues, the body becomes increasingly hypoglycemic – mainly because blood glucose is depleted faster than it is replaced. Liver glycogen depletion and subsequent hypoglycemia are the primary factors affecting fatigue and performance during extended races, especially in instances where muscle glycogen levels are low as well.

The amount of additional carbohydrate that is able to be stored in the body is dependent on diet and conditioning. A conditioned athlete’s muscles are much more efficient at storing carbohydrates than those of an unconditioned competitor. In saturating the muscle by consuming high levels of carbohydrate, the athlete increases their time to hypoglycemic fatigue by a significant margin.

Several methods for carbohydrate loading exist. The most familiar method is the traditional “glycogen stripping” or carbohydrate-depletion/loading method. This method involves the athlete exercising to exhaustion the sixth day before a major competition and for the next three days consuming a high protein-fat, low carbohydrate diet. On day three, the athlete again exercises to exhaustion but for the following three days consumes a high carbohydrate diet.

The aim of this method is to severely deplete the glycogen reserves of the body to cause a “super compensation” effect in carbohydrate stores. Research has demonstrated, though, that this glycogen stripping method may not be necessary to achieve optimal carbohydrate saturation, and that this super compensation effect may not even occur.

Athletes simply consuming a high carbohydrate diet for three days prior to competition resulted in carbohydrate stores comparable to those individuals who performed the glycogen stripping method. In addition, the amount of training performed before the start of the traditional regime has little effect on the resulting carbohydrate stores. Therefore, a well-conditioned athlete may need to do little more than consume a higher quantity of carbohydrates in the three days before competition to receive full benefit.

Optimal carbohydrate loading can be achieved if approximately 600g of carbohydrate is consumed daily for two to three days. It is of little matter if the extra carbohydrate is consumed as simple (glucose) or complex (starch) carbohydrate. Most carbohydrates are digested quickly and enter the bloodstream via the intestine much the same as if glucose had been ingested. Replenishment rates are higher immediately after exercise due to increased insulin sensitivity.

The amount ingested should be about 50 to 80 grams, starting immediately after exercise and repeated every two hours, and continuing for the first six hours. Full glycogen replenishment is usually achieved within 20 hours using this method. Full replenishment of glycogen after an extended event may take several days longer due to muscle damage resulting from repeated cycles of concentric and eccentric contractions.

With the benefits associated with carbohydrate loading it may be helpful to mention one notable disadvantage. Glycogen storage is associated with water retention. Every gram of glycogen stored is linked with 2.7 grams of water. Therefore, a well-conditioned athlete with glycogen stores approaching 800 grams will find their body weight six pounds heavier at the start of a race. This body weight has implications on running economy and performance.

As muscles and other organs oxidize the glycogen stores during exercise, the stored water is released into the body. This may complicate fluid requirements, requiring the athlete to consume less than a non-carbohydrate loaded competitor.

A possible solution for water retention and weight gain is for the athlete to load to a lesser degree and ingest an electrolyte-enriched drink during exercise to help maintain blood glucose and electrolyte balance.

Carbohydrate loading should be viewed as an effective and simple method for improving performance and endurance during extended duration events. Increasing body carbohydrate stores before competition ensures sufficient energy to avoid hypoglycemic related fatigue. What about you – do you carbo-load before distance events?