Plantar Fasciitis & what to do about it

20150603_105836-1Plantar Fasciitis.  I’ve suffered from it before.  A friend is dealing with it now.  It’s that dreadful heel pain and common syndrome that plagues many (estimated 10% of population).
The fascia on the bottom of the foot acts like a shock absorber for the arch and if too much pressure, tiny tears occur in the fascia, resulting in pain, irritation, scar tissue and degeneration of tissues.
Causes:
  • Tight calves, tight Achilles tendon
  • Excessive pronation (feet roll in too much)
  • Fallen arches/High arches
  • Stand/walk/run too long
  • Overweight
  • Poor fitting or old shoes
Symptoms:  Often felt as (stabbing) heel pain and achiness.
  • Usually upon standing after sitting for long periods
  • After standing for long periods
  • First few steps upon awakening
Recently a friend was complaining about heel pain.  After discussing his daily/weekly habits it seems the following are contributing:
  • He is sedentary most of the day.
  • He runs a few times a week – (super, super) fast
  • Has tight calves –  tight fascia and trigger points in calves.
  • Has tight legs in general – trigger points and tight fascia through out length of leg into gluteal muscles.
What to do:
  • Rest – lay off the activities that are contributing.
  • Stretch calves
  • Stretch toes forward, especially the big toe.  Experiment with leg bent/straight.
  • Get massage in the calves and Achilles tendon- especially using techniques of myofascial release, trigger point therapy and/or deep tissue.  Also, there may be adhesions to address for they cause limited movement and extra strain on tissues in calf and foot.
  • Roll foot over a ball or iced water bottle.
  • Point and flex feet in bed upon waking, before stepping onto ground.  This gets the blood flowing and tissues warmed up before pressure is exerted.
My friend had a one hour session last Monday.  We could’ve spent the whole time on his calves, but knowing this is a chronic situation I wanted to address the larger picture/kinetic chain so we included both upper/lower legs – front and back, and the gluteals.  He started stretching his calves and big toe more through out the day and by last Wednesday he noticed no heel pain though still felt tightness in Achilles.  I’ve suggested he have another session this week and next.  Then reassess what is needed for maintenance.  Staying out of crisis is essential to keep an active lifestyle.
There are many ways to approach remedies for plantar fasciitis besides massage, stretching, and rest (wearing a night boot, ultrasound therapy, injections, and new studies with strength training).  Plantar fasciitis is still an enigma for researchers as inflammation is not always present.  Consult your doctor.  If simple solutions do not prove effective – rule out fractures, cysts, or serious ligament tears.
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