Plantar Fasciitis is a painful inflammation if the connective tissue in the sole of your foot. The fascia in your foot essentially forms a sheet of tissue, running from the heel forward to the base of the toes. This fascia can undergo damage by way of micro-tears from unsupportive footwear allowing your arch to drop, trauma to the fascia itself with injury, and poor mechanics of the foot during everyday activities and exercise. These small tears do heal, but if the original strains upon the fascia remain they can heal as small deposits of scar tissue, and over time cause shortening and tightening within the whole plantar surface.
The pain is classically felt in the sole of the foot, often around the base of the heel, and extending through the whole underside of the foot in time. It is worst walking without supportive shoes or on hard surfaces, and like many inflammatory conditions is worst in the morning and then again later in the day as it tires. Over time, without intervention the plantar fascia can become short and fibrotic and your symptoms often become worse rather than better.
Obviously the plantar fascia itself is isolated in the foot and is the source of the pain you feel. But, that is only part of your pain picture. One of the main actions of the foot is to transmit and disperse weight effectively up into the lower limb. If there are alignment or restriction concerns in the knee or hip for example, then the load is increased on the foot itself, including overload to the plantar fascia. It is very common to see plantar fasciitis develop after an ankle sprain or knee sprain, as the loading onto the plantar fascia is significantly altered with the injury related gait changes. Another common trigger is poorly fitting and unsupportive shoes, especially when combined with a new or increased exercise plan. The plantar fascia needs some degree of external support from a shoe to help it manage repetitive impact sports such as running.
The best success with home treatment is when you work out that you have plantar fasciitis early, and then start a consistent home management plan. Treating your plantar fasciitis with denial rarely works!
Start with the widely applicable piece of recovery advice – what feels good is good, and what feels bad is bad. If you can run for 20 minutes without pain then simply do that for now; don’t run for 40 minutes. Start with a stretching and strengthening plan that covers your whole lower extremity
1. Marble pick up. Practice picking up small marbles or stones from the floor by scrunching up your big toe and second toe. Aim for ten of these, and then start increasing to 2 sets.
2. Tissue scrunching. Place a tissue on the floor and scrunch the tissue up with your toes (keeping your heel on the ground). Aim for ten and then increase to add another set.
3. Prayer posture. Sit on all fours, tuck your toes under and then sit back on your heels. Remain in this posture for 30 seconds and edge yourself further into the stretch with each deep breath. Repeat.
4. Self massage. Use your thumbs (or the rubber end of an unsharpened pencil) and push into the sore points in the sole of your foot. Try holding that pressure until it starts to feel better, and/or wiggle your toes to help the tight spot release. Move around to the top of your foot and again push on any sore spots between your toes. Continue on looking for sore spots in your calf muscle and he muscle that runs along the front of your shin.
5. Stretch your calf muscles by standing on the edge of a step and letting your heel drop downwards. Hold for a good 20 seconds and then repeat the same stretch but with a slightly bent knee to get the deeper muscles.
6. Wear supportive shoes. Ditch the jandals, scuffs, high heels and bare feet for a while. No one will see you first thing in the morning in your dressing gown and sneakers!
If the above stretching and activity modification doesn’t resolve your plantar fasciitis symptoms, then it is time to seek further evaluation and treatment. Osteopaths are trained to identify the biomechanical issues in your body that may be contributing to overload on your plantar fascia. It is likely that your treatment would involve assessment, exercises, manipulation and soft tissue release. Surgery is a poor option for plantar fasciitis, so it really is a case of seeking help when needed, keeping up the home exercises and finding yourself a good pair of supportive shoes.