The plantar fascia is a thickened band of connective tissue found on the bottom of the foot that connects the heel (calcaneus bone) to the 5 toes. The fascia is made up of collagen fibers running in a longitudinal fashion which functions to support the foot muscles, acts as a shock absorber, prevents flattening of the arch of the foot and provides important sensory information to the brain regarding foot and ankle position.
Plantar fasciitis can be an acutely painful inflammatory process presenting with a sharp pain around the sole of the foot near the heel. As an aside, any medical diagnosis ending with ‘itis’ essentially refers to a condition with inflammation. Other terms commonly used to refer to fasciitis include calcaneal spur syndrome or calcaneal enthesopathy pain.
Symptoms of Plantar Fasciitis:
- Pain and tightness at the base of the heel or arch of foot first thing in the morning or aggravated with walking, while pushing off the heel or during weight bearing – standing for long periods
- Heel and knee pain
- Decreased ability to dorsiflex the foot (raising the foot up towards the knee) with increased pain when pressing on the calcaneus.
It is thought that plantar fasciitis can be caused by a contraction of and subsequent shortening of the calf muscles and plantar fascia. Research show that plantar fasciitis can become chronic if not addressed in its early stages as the collagen fibers begin to degenerate or suffer from wear and tear.
Predisposing causes include:
- Sedentary lifestyle with obesity (as excess weight puts more stress on the bones and tendons of the foot) -or the opposite –
- Athletes: runners, dancers, rock climbers, soccer players.
- Calf muscle tension and contracted shortened muscles often with a lack of flexibility in the ankle.
- Overuse: the plantar fascia can be stressed by a suddenly increasing the intensity or duration of walking or running or standing for prolonged periods.
- Repetitive strain or direct trauma to the plantar fascia -an occupation where one is standing for long periods, or trauma such as jumping onto a pointed stone or hitting one’s heel on a sharp object.
- Inadequate footwear: thin soles, lack of cushion, wearing shoes with poor arch support and the long term wearing of high heels.
- Weak foot arches and varied foot shape: individuals with very high arches or flat feet may experience more discomfort.
- Muscle weakness in the buttocks: the gluteus medius assists to keeps the pelvis level. When this muscle is weak, the pelvis drops down a little on the affected side, then the knee drops. This creates a domino effect- impacting ones ability to walk. An individual is less able to weight-bear through the middle of the foot. Gravity and the shift in body forces result in a change of gait (with more weight being placed through the inside of the foot) and consequently extra pressure is put on the plantar fascia.
- Underlying health conditions such as arthritis or bone spurs may predispose.
How can Manual Osteopathy Assist?
During an initial appointment, the osteopathic manual practitioner will review the biomechanical chains from foot to knee and up the back; then will decide which areas need addressing. Specific osteopathic techniques, lifestyle recommendations, stretching and exercises would then be given as appropriate.
Treatment options for plantar fasciitis:
- Plantar fascia and local soft tissue massage
- Hot or cold therapy
- Stretching – calf stretches are very important. Such as stretching the calf off a step, or using a wall.
- Rest your foot regularly.
- Hot or cold applications – initially for the first 5 – 7 days during the acute period, apply ice (frozen peas wrapped in a tea towel works well) to the bottom of the foot. Research shows it is more effective to apply heat after the initial acute phase.
- Take steps to lose weight, if you are overweight.
- Be sure to warm up your body well before and after exercise.
- Exercise – cut back on weight bearing exercises that impact the heel – such as running (substitute biking, a rowing machine, yin yoga or swimming) initially during the acute phase.
- Avoid exercising on hard surfaces.
- Wear appropriate footwear and insoles – provide additional support with insoles and supportive shoes while the plantar fasciitis is present.
If you are uncertain what foot condition you are dealing with, we recommend visiting your medical doctor first to obtain a medical diagnosis and to rule out other health conditions.
Why suffer in silence! A manual osteopathic practitioner can provide gentle focused treatment for the fascia of the foot. Seek help and you will be active again before long. Learn more about the benefits of osteopathy or book an appointment by emailing Alinear Osteopathy in Vancouver and Port Moody, BC.