The plantar fascia is a thick connective tissue which passes from the heel to the tips of the toes and it provides attachment points for the many muscles of the foot and it creates elastic energy in every step we take.
It’s a super helpful component of our foot mechanics … until it gets inflamed. People tend not to thank it much when that happens!
Common symptoms of plantar fasciitis are pain when putting the foot down, particularly after rest (the first few steps in the morning or after sitting for a while can be agonising), stiffness in the foot and ankle and even pain at night.
It can be caused by poor footwear (pounding the pavements in heels or smart office shoes can be the culprit), overuse in sports like distance running, and in the non-athletic population the most common cause is excessive weight.
In treatment, we often notice other correlating factors like a tight hip on the same side or restricted pelvic and lower back mechanics. This is because in every movement we make we work as a CHAIN. The feet help the hips, the hips help the feet. If this chain is inefficient, some parts of the body get overloaded.
In any diagnosis, it’s not only important to know WHAT is going on, but also WHY it is happening, and this is where treatment is so important with things like plantar fasciitis.
Our plantar fascia has connective tissue attachments which are continuous with the Achilles tendon, which in turn becomes the calf muscle. Stretching this muscle can be your best ‘way in’ to releasing the plantar fascia
When sitting and relaxing, you can roll your injured foot on a ball to create pressure. I’ve heard many people say to use a golf ball, but I think that’s a little mean for something that can be so tender and I don’t think a golf ball gets the right traction in the tissue either. We find a lacrosse ball is better. It has the Goldilocks-zone of firmness and traction in the tissues!
There is evidence to show that using something known as an ‘eccentric load’ in the calf muscle can help the plantar fascia. An eccentric load is where one puts stretch into a muscle while working it.
In the calf, the way you would do this is rest the ball of your foot on the edge of a step and slowly lower your heel below the level of the step. Use your ‘good’ foot to support you as much as you need to, but try to take some weight in the injured foot. Slowly push yourself up from this position using the bad foot as much as you can without pain. You can do as many reps as feels comfortable, somewhere between 5 and 20, depending on what stage you are at with things.
If it has not been overuse through running or bad shoes that has caused your plantar fasciitis, it may be your body’s response to excessive weight.
I often find that pain and injury can be the catalyst someone needs to make the lifestyle changes they know they need to make, but never found the time.
I always say, our bodies can’t talk to us in English, they can only talk to us in signs and symptoms. Sometimes pain is our body’s way of telling us to make change. In this case, losing weight won’t just help the plantar fascia, but it will also help all the other body systems too.
Basic off-the-shelf orthotics can be helpful in the short-term to take the pressure off the heel-strike in walking and to give a little support to the arch mechanics.
Although this is not getting to the root cause of the issue, it can help relieve the symptoms initially.
Plantar fasciitis is notoriously stubborn, but getting treatment can help accelerate recovery by dealing directly with the tissue strain and helping the whole mechanical chain above. By having hands-on work and using unique and personalised exercises, you can speed up the tissue healing and reduce the inflammation.