Written by: Amy Hudson (Accredited Exercise Physiologist)
Have you ever experienced a sharp, stabbing pain in your heel when getting out of bed in the morning; or after resting for a period of time?
You might be dealing with Plantar Fasciitis; one of the most common causes of heel pain. Whilst the pain might be experienced in your foot, the causes of this deliberating injury can be connected to problem in other areas of your body.
Statistics show that unfortunately Plantar Fasciitis is a common injury experienced by many Australians; with 1 in 10 people reportedly suffering from plantar fasciitis at some point in their lifespan.
The most common demographic who suffer from plantar fasciitis are middle-aged adults, particularly females.
As with most injuries we treat at Inspire Fitness & Exercise Physiology; our examination of the causes of this pain ensure we assess the whole lower body to consider all the biomechanical factors contributing to the onset of this injury.
In this article we aim to overview the factors which contribute to the onset of Planar Fasciitis; and the treatment plans we use to ensure a full return to walking / running pain free.
What is Plantar Fasciitis?
Plantar Fasciitis is inflammation of the Plantar Fascia. Plantar Fascia is a thick band of connective tissue that runs along the bottom of your feet all the way from your toes to your heel. The fascia acts as a rubber band that supports your arch and absorbs shock as you walk or run.
When the plantar fascia gets overworked, overstretched or put under constant strain, tiny tears can form, leading to pain and inflammation. This pain is usually felt in the heel or the arch and can be at its worst in the morning or after long periods of sitting.
The plantar fascia is part of the ‘posterior chain,’ which includes your calves, hamstrings, glutes and even muscles along your spine. When one link along the chain is tight, this can create a domino effect along the chain. Thus, when someone presents with plantar fasciitis you can often find tight hamstring or poor posture along the posterior chain.
How Can you Treat and Prevent Plantar Fasciitis?
Stretching
Standing calf stretch
In a standing position face a wall with your hands placed on it for support, place one leg a comfortable step behind the other, keeping both feet facing forward. Keep your back leg straight and your heel on the ground, place your front foot up against a wall (almost parallel to the wall) and lean forward bringing your hips towards the wall until you feel a stretch in your calf. Hold the stretch for 20-30s each leg, repeat 2-3 times.
Seated Hamstring stretch
Sit on the ground with one leg bent with the foot facing inward , Extend the other leg forward, then hinging at the hips to reach towards the toes (making sure to keep the back straight), feeling a stretch in the back of the thigh. Hold for 20-30s each leg, repeat 2-3 times.
Foot roll out
Sit comfortably in a chair with your feet flat on the floor. Place a tennis ball or golf ball under one of your arches and roll it back and forth from the heel to the ball of your foot applying gentle pressure for a few minutes to massage and stretch the plantar fascia ligament.
Strengthening
Foot towel scrunch
Sit in a chair with a towel on a smooth, non-carpeted floor (such as wooden or tile floor). Place the heel of one of your feet on the towel. Using only your toes, grasp the towel and pull the end of it towards your body, in a slow controlled manner. Hold for a few seconds and then gently relax your toes. Once you have scrunched the entire towel, gently spread it back out and repeat the process on the other foot.
Calf raises
Stand near a wall, chair or table and place your hands on it for stability. Stand with feet hip width apart. Push through the balls of your feet,lifting your heels as high as possible, slowly lower your heel snack down to the floor. Perform 2-3 sets of 12-15 repetitions.
Plank
Begin in a plank position, facing down with your forearms and toes on the floor. Your elbows should be directly under your shoulders and your forearms are facing forward. Make sure to relax your head and look at the floor. Hold for 20-60 seconds, repeat 2-3 times.
Glute bridges
Lie on your back with your knees bent, feet flat on the floor hip width apart, your arms should be by your side. Gently tighten your abdominal muscles and press your lower back into the floor and engage your core. Squeeze your glutes and press through your heels to lift your hips off the floor, creating a straight line from your shoulders to your knees. Pause at the top of the movement, squeezing the glutes and keeping the core engaged, slowly lower your hips back to the starting position. Complete 10-12 repetitions, repeat 2-3 times.
Please note: these are just a few exercises, there is plenty more that will provide value, these are examples that are high effective to improve mobility and increase strength
Footwear
Assess your footwear to ensure you have adequate support of your arches and proper cushioning to absorb impact on your feet when walking or running. Wear supportive shoes with proper arch support – especially if you are on holiday and have increased your use of thongs. Support of a podiatrist is the best strategy to ensure your footwear is conducive to giving you maximum support and cushioning.
Completing these stretches and exercises can help reduce pain, improve mobility and more importantly prevent future occurrences. As sometimes we will treat the symptoms not the underlying problem along the back chain it is important to not only address the fascia but work along the whole chain to reduce the risk of it returning or causing other injuries to allow you to continue with your activities of daily life without pain.
If you are looking for further guidance or assistance, please do not hesitate to contact the Inspire Exercise Physiology team at Inspire Fitness.
References
1. Bolívar YA, Munuera PV, Padillo JP. Relationship between tightness of the posterior muscles of the lower limb and plantar fasciitis. Foot & ankle international. 2013 Jan;34(1):42-8.
2. Cutts S, Obi N, Pasapula C, Chan W. Plantar fasciitis. The Annals of The Royal College of Surgeons of England. 2012 Nov;94(8):539-42.
3. Myers TW. Anatomy trains: myofascial meridians for manual and movement therapists. Elsevier Health Sciences; 2009.