Plantar Fasciitis is the most common foot condition of athletes and non-exercising women. The pain from Plantar Fasciitis can range from annoying to severe. Every basketball season, it will cost some player a few games but chances are that you are not a professional basketball player. When you get hit with Plantar Fasciitis, you end up hobbling around; unable to work, play, or do just about anything that requires you to be on your feet. Professional athletes have access to some of the foremost experts on sports injuries and millions of dollars in diagnostic and rehabilitation equipment. If you’re a recreational athlete, stay-at-home mom, or any other average person you need the ability to recover from this condition on a much lighter budget.
Before we discuss treatment options for Plantar Fasciitis, you should understand exactly what this condition is and how it is caused. Simply put, Plantar Fasciitis is an inflammation of the fibrous band of tissue that runs from the heel of your foot to the base of each toe. This fibrous band is called the plantar aponeurosis or the plantar fascia. It is shaped like a fan starting from a small bony prominence on the bottom of the heel and extending down the foot to the toes. One of the main functions of the plantar fascia is to support the arch of the foot. A good healthy arch in the foot improves the biomechanics of your walk and helps you avoid complications from other foot conditions.
One of the most common causes of Plantar Fasciitis is the shortening of the plantar fascia. If your foot is held for long periods of time in a position where your toes are pointed, the plantar fascia may become shortened. This is because tissues adapt to the stresses put on them. This principle is based off of Wolf’s law, that form follows function and vice-versa. If you hold the plantar fascia or any body tissue in a stretched position for a prolonged period of time, it will begin to take on the stretched shape. Other materials besides body tissues do this also. For example, the neck of a T-shirt will become permanently deformed if it is stretched too much.. Within the body muscles, tendons, or ligaments that are in a shortened position for any length of time will become tighter and shorter.
High heeled shoes commonly worn by women are notorious for leading to the eventual shortening of the plantar fascia. This is because they hold the foot in a pointed toe position for a long time. Over days, weeks, or months of repeated use, the plantar fascia can shorten and become inflamed whenever the foot is in normal flat shoes or barefoot. The shortened and inflamed plantar fascia can also place increased pressure on the muscles, tendons, and ligaments of the foot, all of which are pain sensitive.
Another common cause of Plantar Fasciitis is weak or inhibited foot muscles. This is how athletes typically develop this condition. Muscles in the foot are critical in supporting the arch as well. If these muscles become weak or strained, the plantar fascia needs to pick up the extra load. In the process it becomes inflamed as it is stretched and damaged. In these cases the problem will usually not go away until the injured muscle is allowed to heal.
How can you know if you have Plantar Fasciitis? A foot problem like this should be diagnosed by a qualified professional such as a medical doctor, podiatrist, chiropractor, or athletic trainer. This is because these people are trained to rule out other, more serious foot conditions which an untrained person might not recognize. You might suspect that you have Plantar Fasciitis if you have one of or some combination of the following symptoms:
- Heel pain Pain in the arch of the foot
- Pain is worse in the morning
- Pain is worse when walking uphill
- Pain is worse with dorsiflexion of the foot (Bringing toes up toward your knee)
Plantar Fasciitis is not a permanent condition, lasting from weeks to months depending on when and how you treat it. There are some treatments that are aimed only at relieving the pain associated with Plantar Fasciitis. Of course you may think that is the whole point: to get rid of the pain. However, pain relief is not the same as correcting the problem. In fact, focusing on pain relief can make the problem worse in some cases, allowing you to damage your foot further without feeling the resulting pain. Approaches like cortisone shots or non-steroidal anti-inflammatory drugs (NSAIDs) as a primary treatment for Plantar Fasciitis carry additional risks such as degeneration of the plantar fascia or even gastrointestinal bleeding.
There are a number of safe and effective conservative approaches to treating Plantar Fasciitis and the pain it causes. The use of a deep heat therapy (blood flow stimulation) and cold compression therapy remain the Gold Standards. One other effective and conservative treatment for Plantar Fasciitis is stretching. It’s simple and it makes sense when you think about it Remember the example of women who wear high heeled shoes? Walking around all day long with the toes pointed all the time shortened the plantar fascia, causing inflammation and pain. The way to undo a problem like that caused by high heeled shoes would be to wear high toed shoe instead. You won’t find any shoes like that though because a shoe designed that way would be almost impossible to walk in.
High heels don’t just shorten the plantar fascia, they shorten the calf muscles as well. Whenever you stand on your toes these muscles contract and shorten. Tight calf muscles can increase the problems associated with Plantar Fasciitis. When this muscle is tight it makes it difficult to dorsiflex the foot and can increase pain as well.
The simple solution to both the shortened plantar fascia and shortened, tight calf muscles is regular stretching. Calf stretches are effective for lengthening both the calf muscles and the plantar fascia. When you have a problem, this may be uncomfortable at first. Many doctors will tell you to avoid flat shoes or walking barefoot because this will increase the pain of your Plantar Fasciitis. While this is true, it is the best way to start stretching these tissues out. Switching to a flat shoe with a comfortable arch support will begin to stretch the calf and the plantar fascia in a gentle way.
In addition, deep sustained stretches of the calf muscles will further help the problem. One way these can be done is by performing a lunge with one foot while leaving the heel of the other foot planted on the ground. Leaning into the lunge will stretch the calf muscle of the back leg. Do not bounce as you stretch as this may cause tendon damage. A nice, steady stretch held for 30-60 seconds will give you the desired results. You should stretch both legs even if only one side is bothering you. This should be repeated several times per day. You can stretch in the elevator, while you brush your teeth, at the bus stop, standing in line to pay for your groceries, or any number of places. You should definitely stretch before any sort of physical activity and first thing when you get out of bed in the morning.
Try stretching and you will notice that after a period of a week of frequent stretching your symptoms will be decreased and your condition will be well on its way to a full recovery.