Los Angeles Angels’ slugger Albert Pujols may be suffering from foot pain, but will he let it end his season early? Not a chance. “This is my job,” he told the press before Thursday night’s game against the Toronto Blue Jays. “I still want to play.”
The nagging pain must be frustrating for Pujols, who has already undergone surgery to repair a plantar plate in 2015. Nevertheless, he’s determined to press on: “I’ll have plenty of time to take care of myself in the off-season.”
A Repeat Problem
This is the latest battle in the ongoing war Pujols has waged with plantar fasciitis over 3 years. His first bout, affecting his left foot, took him out of the 2013 season in midsummer with only 99 games under his belt. This time, the condition has flared up in his right foot.
But Pujols and Angels’ manager Mike Scioscia are confident that he’ll be able to play through the pain. If play becomes too risky, then the two will “definitely have a conversation,” remarked Scioscia, but for now, “Albert wants to play. That’s what he’s here for. He’s a great role model for younger players.”
Weighing the Risks
But the decision to keep Pujols in the game despite his injury may not be paying off for the Angels, who lost 2-7 to the Blue Jays. It was the eighth loss of a nine-game stretch, the final nail in the coffin of their first losing season since 2013. For outside observers, it’s hard not to read too much into these coincidences.
Pulled in Two Directions
Plantar fasciitis is one of the most common causes of heel pain in athletes and non-athletes alike. The pain is caused by inflammation of the plantar fascia, the thick band of tissue in the sole of your foot. The connective tissue joins the heel to the forefoot and is instrumental in flexion and weight-bearing.
“Each step you take exerts a downward force on the midfoot, pushing the heel and forefoot further apart and stretching the plantar fascia,” Dr. Bob Baravarian explains. “When this tension becomes excessive over time, it can cause dozens of tiny microtears in the tissue, triggering the body’s inflammatory response.”
They also start to feel it when they stand up after sitting for a long period of time, or just as they’re warming up into physical activity.
Plantar fasciitis is the bane of existence for athletes whose feet must constantly absorb the shock of landing hard on the ground. Runners, ballet dancers, and of course baseball players know the condition well. It’s also common in people spend a lot of time on their feet – say, at work – and who have flatfeet or unusually high arches.
Treating Plantar Fasciitis
In the vast majority of cases, plantar fasciitis can be treated conservatively. First, runners should reduce the length of their stride and make sure they’re striking the ground heel-first rather than with their mid- or fore-foot. This should take some of the tension off the plantar fascia.
Next, athletes should sleep with a night splint. This is a device that holds the foot in a flexed position at night. When the foot is allowed to relax at night, the microtears heal in a way the pulls the plantar fascia tighter. This is why patients experience so much more pain in the morning – the newly-healed tissue is tearing all over again upon holding weight. A night splint can ease this cycle.
Last, patients should visit their foot and ankle specialist to get fitted for a custom orthotic. A small heel wedge inserted into the shoes can lift pressure off the plantar fascia and give the injury time to heal properly while the patient continues their normal activities.
Conservative treatments are the least risky and should be exhausted first, but if the pain persists, then regenerative therapy such as PRP or stem cell injections, or surgery could be effective alternatives.
As a teaching institution, University Foot and Ankle Institute’s Fellowship Program is among the most advanced in the nation.
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