The Big Arch: Plantar Fasciitis Causes and Treatments

By Emily Stewart. Published on January 14th, 2018

Plantar fasciitis is one of the most frequently cited sources of chronic pain for everyone from runners to office workers, children to the elderly. Most people presume it’s an issue with the foot-- something within the mechanics of 26 bones, 33 joints, muscles, and connective tissues (ligaments and tendons). True, plantar fasciitis is symptomatic in the arch of the foot, where a ligament connects the ball to heel. And yet, its causes and treatment usually occur in much different parts of the human biomechanical model.

Painful feet.
Photo by Imani Clovis on Unsplash.

Your Foot and Movement

Certain forms of exercise, like yoga and Pilates, assert that what happens in the foot bear impact all the way up the body. This is true in its current form and the reverse. The newest biomechanical research recognizes the body as being made of integrated connective tissue (muscle “trains”). No movement occurs in isolation; all movement is caused by and has impact on associated functions across the body. Research studying anatomy trains and Tensegrity medicine shows us that a motion originating in the center of the foot can be traced to the front of the head, criss-crossing the anatomy. And this is just one of the cross-sectional, three-dimensional ways that the body creates action.

When we move in any way, the body's mass is displaced. There occurs a chain reaction to compensate the initial displaced position. For instance, when we walk our body is momentarily falling forward. The front foot responds with a forward motion. Via stabilization, we move inward slightly. This inward rotation of the foot is called pronation. As the back leg lifts, the front foot then flexes at the ankle so that the back foot can move forward to re-stabilize. Eventually, the ankle must lift entirely off the ground, bending at the toes to complete the motion. When the foot pushes off the ground it supinates slightly-- the outside of the foot presses downward. A healthy gait involves foot flexion and extension in agile, pain-free succession.

Foot position going up the stairs.
Photo by Bruno Nascimento on Unsplash.

What is Plantar Fasciitis?

Plantar fasciitis (PF) is an issue with the plantar fascia, a ligament that connects our heels to our toes. After repeated strain, or chronic weakness, the ligament becomes inflamed, weak, or swollen so that the heel or bottom of the foot hurts. Most people feel a sharp, stabbing pain; notice a slight swelling or redness on the bottom of the feet; and/or suffer from very tender footbeds. If the plantar fasciitis is treated but this discomfort continues, it could be a sign of arthritis or tarsal tunnel syndrome, which is a stress fracture in the bones of the feet.

Causes

The most common reason for PF is over-use: the same repetitive motion again and again; wearing poor shoes; walking on very hard surfaces; or moving in such a way, due to existing muscle imbalances, that creates a disorganised gait.

Some people are prone to Plantar Fasciitis because of their inherent alignment: pronation (inward roll of the feet); extremely high arches; or flat feet are all examples of alignment that is predisposed to Plantar Fasciitis.

Another easy-to-identify cause of PF are tight muscles down the back of the leg, especially achilles tendons or calf muscles, that prohibit the ligament from its full range of motion.

Feet at work!
Photo by Lindsay Henwood on Unsplash.

Improper shoes are a culprit and a victim. If you have tight calves, do not wear heels; if you wear heels, you could get tight calves. Finally, overweight people often suffer from PF.

It's all connected

The logical next step in this article is, “How to cure plantar fasciitis”. But, as we explained before, nothing in the body can be disconnected from the rest of the system. Sure, there are helpful tricks to relieve momentary PF symptoms. But in order to actually “cure” the affliction the rest of the body alignment must be analysed, and potentially organised, before the PF subsides.

For instance, over-pronation (foot rolling inward) is often caused by a foot or ankle that's inflexible. This impedes the bend of the foot as it travels forward, which then impedes the ability for the knee to move completely forward. The body's mass can't land on top of the foot as it ought to, so the body compensates by rolling the foot inward to create a wider surface. If we try to solve the PF alone we might actually create new issues on the body because its means of compensation has been removed.

Footsteps on the sand
Photo by Felipe Correia on Unsplash.

What does this mean? The symptoms of your PF are probably tied to disorganisation within your complete anatomical train. You'll know this if attempts at alleviating PF either don't work, or if you notice new issues after treatment is pursued. In that case, a more holistic view of bodywork and fitness is recommended.

“Cures”

It's in the human psyche to search for quick remedies when we are in pain. Hence the reason most people try to use arch support, stability shoes, and other orthotics when they suffer from plantar fasciitis. While these remedies may provide momentary respite, they're like putting a band-aid on a wound.

In order for the wound to heal, more work is actually being done within the entire ecosystem of the body. In fact, inserts, orthotics, and other remedies can cause more harm than good. Many people develop plantar fasciitis as a compensation for another issues in the body. If we remove the plantar movement without addressing the origin of the issue, we might create more issues than we started with. For this reason many bodyworkers no longer recommend over-the-counter orthotics.

Yoga downward-facing dog Position.
Downward-facing dog pose. Photo by Shutterstock on Unsplash.

The best way to “cure” chronic pain is with a regular regime of exercise, bodywork, and self-care. Certain forms of exercise meet more than one need: pilates and yoga are excellent ways to build strength while massaging muscles, re-aligning the skeleton, and stimulating connective tissue. Here are three examples of plantar fasciitis appropriate exercises:

Downward-Facing Dog Pose

Start in plank pose: from kneeling on your hands and knees, extend your legs straight. Keep your wrists directly under your shoulder, in-line with your shoulders. Then tuck your belly in and raise your hips high to the sky. Keep your head relaxed, chin tucking to your chest. Roll your shoulders away from your ears and down your spine, pointing your elbows toward the ground. Push your heels toward the ground by strengthening the fronts of your legs. Push your hands deeper into the ground, hips higher, and heels down. One day your heels might touch the ground!

Towel Stretch

This one is simple. Sit up with your back against a wall, bum as close to the wall as possible (try to get your entire spine against the wall). Flex your feet, turning the toes toward the eyes. Wrap a towel around the ball of the foot. Pull back on the towel, pushing the heel forward and pulling toes backward. Flex and point the foot a few times to get deep; then hold a flexed foot.

Tennis Ball Roll

Stand with feet hips-width distance apart, directly under the centre of the hips. Place a tennis ball underneath one foot. Lean into the ball with as much push as you can comfortably allow. Roll the ball along the centre of the foot, gently massaging it. Conduct this exercise on both feet, even if only one foot is affected.

Emily Stewart calls herself a “Pi-Fit-Yogi,” teaching yoga, Pilates, and blended classes all around the world. You can reach her at ahumandoing.org.

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