Have you ever been on your feet all day and noticed that the heel or arch of your foot aches? Have you ever gotten up first thing in the morning or after sitting down for a while and the first couple of steps you take are very painful? Is this pain localized in your heel, arch, or just behind the heel area? You may be suffering from a condition called plantar fasciitis (PF).
Plantar fasciitis is inflammation of the plantar fascia, a band of thick tissue that runs from the heel to the ball of the foot. The plantar fascia is designed to help support the long arch of the foot while bearing weight – as in standing, walking, running and jumping. Tension in this fascia is often caused when the foot lengthens (flattens) which is referred to as pronation. Pronation is when the foot “unlocks” the many small bones and ligaments within the foot, allowing the foot to accommodate to the ground & uneven surfaces. We have all felt this flattening when we stand on something uneven like a trampoline or on sand.
This adaptation (pronation) allows the foot to provide some shock absorption, but the increased lengthening in the arch/foot can become excessive. When this happens, the fascia is over-stretched and can cause micro-tearing, pain and inflammation. Let me explain how that seems to happen most often. I have found that virtually ALL of my patients with PF have calf tightness and restrictions. By that I mean their calf muscles are limiting the mobility of their lower leg. When the lower leg is limited from moving optimally, the foot has to make up the additional motion. This is when increased pronation occurs and the plantar fascia becomes over-stretched.
Of course, abnormal foot mechanics, tight/weak surrounding musculature, and overuse areall areas to be addressed. The physical therapy approach often includes stretching, soft tissue release of the muscles & fascia, and some strength/stability training. The majority of the time conservative treatments resolve the plantar fasciitis; however, occasionally surgery is indicated. Surgery may include a combination of techniques available to foot surgeons including lengthening the fascia, removing the spur, & injections
To help release restricted tissues, you can use the foam roller to mobilize your calf muscles. Roll up and down the inside, middle, and outside of the calf for ~30 seconds at each area. You can also roll a golf ball under the arch (along the fascia) for ~2-3 minutes or so as well. Push with a moderate amount of pressure and stretch your calf muscles and plantar fascia 3 times, for 30 seconds at a time. Do this multiple times/day.
- Kibler, B.W. et al. ( Jan 1991). Functional biomechanical deficits in running athletes with plantar fasciitis. Am J Sports Med; 19: 66-71.