Plantar Fasciitis – Treatment and Prevention

 

Plantar fasciitis is a common condition that I see in my practice.  Pain occurs primarily on the bottom of the foot close to the heel, but it can also extend down the arch of the foot.  It can feel excruciating when you take that first step in the morning or when you are about to take off into a sprint. Plantar fasciitis is an inflammation of the plantar fascia, a thick band of connective tissue that runs along the bottom of the foot and connects to the heel.  The pain often lessens as the day progresses and the tissues warm up, but can be quite excruciating first thing in the morning, after standing on hard surfaces all day, or with a sudden increase in activity.

There are many factors that are thought to exacerbate this condition, but no general consensus on treatment protocol.  Some contributing factors may be the height of the medial arch in the foot, the flexibility in the gastrocnemius and soleus muscles (calf muscles), the strength of the tibialis posterior muscle, and even weakness arising in the hips that affects the distribution of forces on the body, thus causing more strain on the foot. [i] Needless to say, there are a lot of factors that can be causing that sharp pain in the bottom of your foot.

Here are a few ways you can address a number of these issues and help to alleviate, prevent, and rehabilitate your foot pain:

 

Arch Support

I find that Birkenstock insoles help a lot of people with this condition. They are comfortable, affordable, and help to support your feet.  Avoid wearing anything that doesn’t support your feet or that overstrains them, such as flip-flops, high heels, or worn out running shoes.

Rolling

To do:  Place a small spikey ball or other rubber ball under your foot. I don’t recommend a golf ball because they are very hard and can cause bruising.  Take a couple of minutes a day to roll out the plantar fascia, making sure to roll out along the base of the heel and the medial arch.

 

 

Calf Stretch

The gastrocnemius and soleus muscles form the back of your calf.  They combine to form the Achilles tendon which attaches to the plantar fascia.  Tight calf muscles will restrict the motion of the plantar fascia, causing tension and possible pain.

First stretch:  Keep your toes pointing forward and lunge with one leg forward towards the wall (shown in picture) Keep the heel of the back foot on the ground and the knee straight.  This will target the gastrocnemius muscle.

Second Stretch: Make sure to maintain this position, but bend the back leg while still keeping the heel down.  This will target the soleus muscle.

Hold these stretches for 30 sec and repeat 3x for each stretch and each leg

 

 

 

Foot and Toe Stretch

To do: Place both knees on the ground and tuck your toes under.  Sit back on your heels, lowering yourself slowly so as not to overstretch too quickly. You will get a nice stretch all along the bottom of your foot and toes.  Hold for 30 sec and repeat 3x

 

 

 

Massage

Massage will break apart any adhesions in the fascia and muscles so that there is a nice glide between structures.  It will also increase circulation to the area which will help to promote healing.  You may feel some crunching as the tight and restricted structures loosen.  This is great to do in the morning before taking that first step out of bed.

To do: small circular motions at the base of the heel and down the arch of the foot.  Start gently and gradually work in deeper.   A series of treatments with your massage therapist is also a good idea as they can work on numerous musculoskeletal issues in a thorough and more targeted way.

 

Doming

Works the arch muscles and the tibialis posterior to control excess pronation

To Do: stand with feet hip width apart.  Press toes downward while heel maintains contact with the floor.  Your foot should form a dome.  Hold briefly and do 3 sets of 10 reps on each foot.

 

Towel Curls

These are done to strengthen the muscles in your feet

To do: place a small towel on the floor and place one foot on the towel. Curl your toes under and pull the towel towards you, hold briefly, then begin again.

 

Therapeutic Taping

Helps to support the arch of the foot and relax tight calf muscles

To Do: I recommend finding an RMT who has training in athletic taping techniques.  They can tape your foot for you after your session with them and demonstrate the proper way to use the tape if you wish to try it on your own.[ii]

[i] www.ncbi.nlm.nih.gov/pmc/articles/PMC385265/

[ii] www.kttape.com