By: Patricia Igar and Brianna Castillo
This article provides more information on plantar fasciitis, its causes, and its treatments. Here at Best Day Fitness, we have a unique approach to “fixing” plantar fasciitis and preventing the pain from happening ever again. First, we will go over what to do, then we will compare our philosophy and treatment strategies to the traditional method.
The first thing you need to do is STOP STATIC STRETCHING!
The plantar fascia is a connective tissue that functions similar to a tight cable that holds up the arch of the foot. It can be compared to bowstring that keeps the bend in the bow. Lengthening this cable by stretching lets the arch lose its tension. Yes, this is the most recommended treatment for plantar fasciitis. However, this is only a temporary reduction of the pain. The most likely cause of the pain is the fact that the underlying muscles of the foot are weak and not doing their proper jobs. When the muscles do not work, the fascia must take over the role of shock absorbing the impact forces from walking and running. This stresses the fascia and ultimately results in inflammation and pain. Which leads to our next recommendation.
Next, you need to STRENGTHEN THE MUSCLES OF YOUR FEET AND LEGS!
The muscles in the lower legs and feet work in tandem to keep the foot and ankle stable when walking and running. The plantar fascia is an extension of the Achilles tendon, which is also an extension of the calf muscles. Strengthening the lower leg muscles helps tremendously in preventing feet pain.
Here are some exercises that can help strengthen those muscles:
This Toe Dexterity Exercise is simple; take a wash cloth and pick it up with your toes.
Start with with your whole foot on the floor. To make this exercise more intense you can come up on your toe or use a destabilizer or BOSU Ball.
Don’t forget to do both sides.
Calf Raises are also super helpful for strengthening the muscles of the foot and calves.
Stand on both legs, with soft knees, and lift your whole body off the floor by coming on to your forefoot and toes. Don’t just bend your knees, make your whole leg work.
These ramps are another great way to strengthen your feet, calves, and legs.
Lay on your back and lift your hips up. While keeping your hips high, raise and lower your heels.
Then, you need to learn how to STOP HEEL STRIKING!
Although wearing shoes is a normal aspect of society and actually required in most businesses, we say don’t wear them! When you are allowed to do so of course, and if you must have shoes on, wear minimalist shoes. Why? Because shoes decrease the sensations of walking and prevent the nervous stimulus the brain needs in order to use the muscles in your feet. So, ultimately, shoes turn off the feed back from your feet muscles. When muscles are turned off, the ligaments and fascia take over resulting in over-use and inflammation, which causes pain. Use your feet!
When the feet can’t feel anything, faulty biomechanics ensue. Do you ever notice when you heel strike? No, because the shoes have “cushioned” your feet and have actually allowed the feet to perform in a manner that is improper and eventually destructive. Unfortunately, most of us have been placed in shoes from an extremely young age and have developed a defective gait that has become habit. Heel striking causes a cascade of problems from the feet all the way up the kinetic chain of the body.
Read further to learn about why plantar fasciitis happens in the first place and more of the reasoning behind the exercises and lifestyle changes we are suggesting.
What is Plantar Fasciitis?
It literally means the inflammation of the plantar fascia. It can be accompanied by pain anywhere along the bottom of the foot, but is usually felt more by the heel.
What does the Plantar Fascia do?
The plantar fascia gives ligamentous support to both the medial and lateral longitudinal arches of the foot. The arches of the foot buffer and dissipate the ground reaction forces during foot contact with the ground. In order to keep the arches strong, but flexible, muscular and ligamentous support is required. (From the textbook: Evaluation of Orthopedic and Athletic Injuries)
What do most people think causes Plantar Fasciitis?
It is widely thought that flat feet, high arches, and/or over-pronation can be root causes of plantar fasciitis.
What is the actual cause of Plantar Fasciitis?
The main culprits are foot muscle weakness and heel striking. There can be many factors involved and one does not necessarily cause the other, however they are all related.
Why do I need to strengthen my feet?
In essence, when the forefoot contacts the ground first, the arch is at its highest and strongest point. As the foot comes down the impact forces are dissipated because of the intrinsic muscles of the foot and calf muscles. You need to have strong muscles and supportive connective tissues in the foot for this to happen.
Think of a bow and a bowstring. Your foot is the bow and your Plantar Fascia is the bow string. A bow’s strength comes from the tension in the bowstring; it needs to be tight to keep the bend in the bow to give it potential power.
When forefoot running, the arch is curved more, and so it has more space to dissipate the force of running. The arch will give (or un-arch) a little to dissipate impact forces as opposed to when you heel strike all the force comes down on the heel.
You need to strengthen your feet because the intrinsic muscles of the foot and the plantar fascia need to be strong for the force of your bodyweight plus the extra force running to be dissipated when you land on your forefoot.
Why is heel striking bad?
Reason 1 – The intrinsic foot muscles and the calf muscles are there to decelerate body weight, not to push off with, as when you heel strike. When the arch comes down fast, the plantar fascia is stressed because it’s doing the job of the foot and calf muscles.
“When the heel initially hits the ground, the foot MUST pronate excessively to allow the foot to contact the ground.” This means that the foot is literally slapping down towards the ground, which results in “the failed execution to dissipate the impact forces of walking or running.” (From The Journal of Athletic Training – Plantar Fasciitis and the Windlass Mechanism: A Biomechanical Link to Clinical Practice)
Reason 2 – When people run or walk with their heel striking first they are reversing the body’s kinetic chain of stable and mobile joints. Usually, the forefoot is stable, the ankle is mobile, and the knee is stable, etc. With heel striking, you are starting the kinetic chain on your heel and this makes the ankle be the stable joint, in turn making the knee have to be the mobile joint…etc. (More on this in the next article)
Reason 3 – When you wear cushioned shoes you are reinforcing bad form. You heel strike but you don’t feel the impact as much as you would if you were barefoot. Cushioned shoes desensitize your feet, which are supposed to give you biofeedback on how you are running and what terrain you are running on. Over time this bad form leads to more problems than just Plantar Fasciitis. Bad form can give you ankle, knee, hip or back pain and eventually injuries.
What is the common “treatment” of Plantar Fasciitis?
The most used treatments are stretching the calf and foot, wearing a boot at night, or using cushioned or stability shoes. These are just band-aids that treat the symptoms of weak feet, but do not solve the underlying problem.
Orthotics turn off the muscles in your feet. It might provide some temporary relief from pain, but will actually weaken the foot and never fix the true problem. They only treat the symptoms and do not address the causes.
Boots or splints worn at night, again, only treat the symptoms of Plantar Fasciitis and do not fix the causes.
What should I do to FIX Plantar Fasciitis?
The true cause of plantar fasciitis is improper biomechanics.
The above suggestions are the steps you should take that will help now and steps that will help in the long run. For now, try these things, but in the end, the life style changes we suggest will help eliminate pain for good.