Do you feel some pain under your heel? If so, then there’s a 70% chance you have plantar fasciitis. Under your feet there’s a ligament called the planar fascia, and its main function is to support the arch of your feet while it also works to absorb impact when you walk, run, or jump. When you have plantar fasciitis it means the planar fascia is inflamed. But what you may not realize is that there’s also a connection between plantar fasciitis and depression.
You get plantar fasciitis when you repeatedly sustain small injuries to the fascia. These injuries can be caused by several conditions that generally stress your feet repeatedly. It can be the result of running regularly over hard asphalt roads, using shoes that don’t offer proper arch support and shock absorption, improper (or lack of ) stretching, and over-exercising. Even obesity can lead to injury, because you constantly force your feet to bear the extra weight.
It’s estimated that more than a million people is affected by this condition every year and about 10% of the population will get it at some point in their lives. It’s fairly common among people who are constantly on their feet, and that includes dancers, people who work in the service industry (like food servers and bellhops), and athletes.
Runners and athletes who play basketball and tennis are more prone to this condition, because they pound their feet constantly against a hard surface for an extended period of time. But most people only seem to notice the physical symptoms. Plantar fasciitis and other forms of injuries can also affect the patient’s mental health too.
Sports Injuries and Depression
Quite a few famous athletes have suffered from depression after they sustained serious injuries. One well-known case involved Picabo Street, who was a media favorite during the 1998 Winter Olympics in Nagano. She blew out her right knee and badly broke her left leg after a skiing accident.
The harm she sustained wasn’t just physical. The injury caused her to withdraw from the world completely. She went to the bedroom of her parent’s house, and she shut herself in. She closed the blinds. She didn’t take any phone calls. None of her friends and family could get through her. And even the TV stayed dark and silent. All she did was lay in bed in a dark room and think miserable thoughts.
Picabo Street wasn’t unique in how she reacted to her injury, however. Other athletes also confessed to bouts of depression when they were sidelined, though the symptoms of the depression may be different. For Kelly Holmes, the middle distance runner who won gold medals in the Athens Olympics 800 and 1500 meters had to overcome a depression that caused her to slash herself with a pair of scissors for every day she was injured. Even the great Serena Williams wasn’t immune to depression due to sports injury, as a long injury layoff led to a deep depression that made her cry all the time and miserable to be with.
Non-professional athletes who run constantly or play regularly can be affected. But nobody really know for sure how often depression strikes injured players, because the question hasn’t received a lot of attention.
One study involving 343 male athletes across multiple sports did show that 51% of them had some symptoms of depression after being injured. About 12% had more serious symptoms and they became moderately to severely depressed. A doctor at the Vanderbilt Sport Medicine Center at the Vanderbilt Medical School also reported that about 1 in 4 or 5 injured athletes who came to their clinic also suffer from depression.
Symptoms of Depression among Injured Athletes
Injured athletes, even the ones who only play their sports during weekends, can be susceptible to depression. There’s a long list of typical symptoms that include feelings of worthlessness, overeating or loss of appetite, and excessive sleeping or insomnia. Problems come up in social and work relationships, patients may feel fatigued or weighed down.
Some athletes may become depressed as long as they’re injured, and their mood may only lift when they begin to heal from their injury. For others with more serious injuries, the depression can last for months. A handful may even think about suicide.
And just as healing can impact recovery from depression, the depression can also affect the how they recover. Their mood can affect how well they comply with their rehab therapy, and depression symptoms like decreased energy and feelings of unworthiness can keep them from trying their best in rehab.
Another part of the problem is the perceived “superhuman”-ness of athletes. There’s a feeling among people that athletes are superior when it comes athletic performance and dealing with pain. And many athletes buy into this view, so much so that they equate the injury to moral weakness.
How Can Plantar Fasciitis Cause Depression?
Surely that doesn’t happen with Plantar Fasciitis right? After all, it doesn’t involve paralysis and broken bones.
Depression is always a possibility even with plantar fasciitis.
- This is especially true when the condition has become severe and the doctor recommends quitting the sports activity for a few months. And with this medical condition, complete recovery can take months, or even a year. The fascia tissue heals very slowly, and it can easily become aggravated.
- Pain is also the main symptom of plantar fasciitis, and there’s a definite connection between pain and depression. Pain can cause depression, and what’s more, depression can also cause additional pain like headaches and back pains.
Fortunately, several treatment methods can deal with both pain and depression. Antidepressant medications can also relieve pain, as both conditions share the same chemical messengers in the brain. Talk therapy and stress-reduction methods can also be helpful. And some pain rehab programs deal with both the physical and psychiatric aspects to pain treatments.
- The patient may be told to rest from the sport, and that can be depressing for dedicated runners and athletes who become inactive. Immobility, which may be necessary especially when there’s a need for a cast to rest the foot, can cause depression.
- Lack of exercise can also lead to weight gain because the patient cannot work out, and that can also be a problem that leads to depression. A weight gain can cause a patient’s self-image to worsen and their self-esteem may plummet. Their embarrassment over their out of shape body can lead to social isolation. All these are known contributors to depression. In fact, the inability to participate in physical activity increases the chances of developing either or both depression and weight gain.
- Some cases require more serious treatments such as surgery, and these procedures can be costly. In addition, they may not work satisfactorily and there’s a chance that some complications like nerve damage can occur. These possibilities can be depressing, and when they actually do happen it can be psychologically devastating.
If you’ve been diagnosed with plantar fasciitis, then depression is a definite possibility you need to watch out for.
- The key to beating depression is to establish and foster a sense of self-worth and purpose. You’re not just an athlete. Think of all the things you can still do, and remember all the people who love you and respect you for who you are, and not just because of your athletic prowess.
- It’s crucial that you familiarize yourself with the possible symptoms, so that you can recognize and address the problem. Don’t wall yourself off from other people, monitor the state of your social relationships for increased number of arguments, and take note of how you feel.
- If you think you have some symptoms of depression, see a psychologist. The psychologist can monitor your psychological condition, and can help you form coping techniques customized to your condition and your case.
- Try to follow a regular sleep schedule. Always go to bed at the same time, and follow a ritual you can perform each night to condition your body to prepare for sleep. Make sure you eat a healthy diet, and your doctor or a nutritionist can help you prepare a diet that takes your vacation from your sport into account. Since you’re not burning off as many calories as before, you may have to cut down on your calorie consumption.
- You must follow all the medical instructions you get. It doesn’t matter if you don’t feel like doing your physical therapy—you must do it anyway.
- Pick up another sport that’s less punishing for your feet. If your doctor has forbidden you to run, or play basketball, tennis, and baseball, ask if you can try golf. Even those with knee injuries can play golf, so a case of plantar fasciitis may let you play.
Golf is great because it can satisfy your competitive nature, and it can be challenging so that you can focus on it instead of dwelling on a sport you can’t play for now. And with the golf carts, you can easily rest your feet.
You can beat plantar fasciitis, and in fact most people can do so within a year. And you can beat depression too. With the right support, training and mindset, you’ll come out a winner in the end.