What is plantar fasciitis and is it causing my foot pain?
Every year more than 2 million Americans are affected with planter fasciitis. This makes it one of the most common causes of heel pain.
Plantar fasciitis refers to pain and inflammation of a thick band of tissue, called the plantar fascia, that runs across the bottom of your foot and connects your heel bone to your toes. This thick band of tissue, along with muscles and ligaments, helps support the arch of the foot. When these arch-supporting fascias, muscles and ligaments are placed under uncommon forces (either overloaded or overstretched), they develop small tears that are painful. Your body begins to heal these tears while you sleep. Unfortunately, this healing is a tedious, slow process that cannot be completed overnight.
When you wake up and place stress on these tissues, the stabbing pain you feel in the foot and heel is the re-tearing of these inflamed, under-repair tissues. After a few steps in the morning, these tears have reached their original size and no longer cause pain. Unfortunately, however, with any extended period of rest, your body will repair these tissues enough for your next initial steps to be painful.
Plantar fasciitis is particularly common in runners. In addition, people who are overweight and those who wear shoes with inadequate support are at risk. One of the most common causes of plantar fasciitis is previous surgeries and injuries of the hip, knee, ankle and foot. Supporting ligaments, fascia and muscles anchor to the skeletal structure and provide movement for joints. Many times these joints or supporting structures are injured or left limited following surgery and never ideally addressed. This leads to repetitive and chronic abnormal stresses on these structures that will lead to swelling and inflammation of the tissues. Over time, these tissues will break down and begin to tear. Until these issues are addressed, each step only encourages further damage.
Another common cause of plantar fasciitis is sedentary underuse. The body is designed to maximize function based on the stresses applied to it — that’s why gymnasts who train daily become more flexible, weightlifters gain strength, and runners become faster. When a person spends the majority of the day sitting, the body isn’t required to maintain the supportive structures necessary for standing and walking. These tissues begin to atrophy over time until they are unable to sustain the normal force of bearing weight and begin to tear.
When treating plantar fasciitis, it’s important to address past injuries and imbalances to restore ideal biomechanics. Proper chiropractic care can help address these injuries no matter how old or how chronic. Once the imbalances are corrected, the stresses are removed and the body readily repairs the tissues. Oftentimes people try orthotic inserts for their shoes to help eliminate the problem. In many instances, addressing these dysfunctions with chiropractic care will eliminate the problem without orthotic inserts. If you chose to wear orthotics without addressing the underlying dysfunctions, the orthotics will only influence less than ideal function.
Exercises to strengthen your plantar fascia will help maintain the natural supportive arch and prevent future tearing. An easy exercise involves rolling up a washcloth, placing it on the floor, and trying to grasp it with your foot. The key involves using your toes to curl inward around the washcloth, while trying to contract the muscles between the ball of your foot and your heel. As with any exercise, form matters more than repetitions. Be sure to use an icing routine following any strengthening exercise to lessen any post-workout aches. Freezing a bottle of water and rolling your foot over it is an ideal way to help decrease inflammation.
If you have questions about the causes, effects, and treatments discussed, or would like to know more, please feel free to email me at pathwaysth@gmail.com and put “Heel Pain” in the subject line.