Many athletes and active individuals are familiar with plantar fasciitis as pain in the arch and heel of the foot. Less familiar is what causes the condition, and how to treat it for relief and recovery.
Plantar fasciitis is an inflammation of the plantar fascia. The plantar fascia is a web of thick connective tissue that runs from the heel to the toes. It provides stability to the arches of the feet. With every step, the tissue will help maintain the integrity of the foot's arch along with muscles along the bottom of the foot. Like any soft tissue, it is susceptible to overuse and injury. A Too-Much-Too-Soon approach to athletics, standing long periods on hard surfaces, and engaging in athletics on hard surfaces (volleyball, tennis, etc.) can all cause micro injury to the tissue, as well as subsequent development of painful, restrictive adhesions in the arch.
Characterized by pain in the heel and arch—especially the first few, excruciating steps in the morning—plantar fasciitis affects a large population of athletes and non-athletes. So once this painful and often severely-limiting condition sets in, what are the options for treatment and recovery? Here are 3daily keys to treating plantar fasciitis at home:
- Roll the tissue: Using either a tennis or golf ball (depending on what your condition can tolerate), roll your bare foot over the ball as it lies on the ground. This is a form of self-myofascial release, and will help break up the scar tissue and adhesions that are responsible for much of the pain in your foot. 5 minutes/foot
- Bonus Tip: use a water bottle with frozen water in place of a ball. It will provide you with the myofascial release, as well as cold-therapy
- Don't forget the calves!: The calf muscles pull directly on the heel via the Achilles tendon. Pulling in opposition to this are the muscles of the arch as well as the plantar fascia. It becomes a virtual tug o' war for your heel. Use a foam roller to address the calves in the same manner as the balls/bottle are addressing the arch. Roll from ankle to knee, and hold the position over any knots or sore spots. 5 minutes/leg
- Stretch: After rolling the calves and arches, make sure to stretch the tissues. The stress applied from stretching will guide the remodeling of tissues after breaking down the adhesions. To hit all areas, I have patients start by facing the wall in a lunch position with the affected leg as the back leg. Lean into the wall with the back leg straight to stretch the gastrocnemius (upper calf). Still leaning, bend the knee of the back leg and move your hips backwards from the wall to a position more over the back foot—this addresses the soleus or lower calf. Finally, with the leg bent, raise up the heel of your back leg to stretch the arch. 3 sets of 30 seconds for each stretch, each leg
If after a few weeks of this procedure and avoidance of any activities that cause/create pain you do not have any relief, contact your local sports medicine specialist. More aggressive tissue work may be necessary, along with supportive taping techniques. Beyond that, cortisone shots are occasionally used, and surgery is necessary in a reported 5% of cases—I have never personally known of anyone to have had that in more than a decade of practice.
If you have any questions regarding the tips above, or your own case of plantar fasciitis, please contact Dr. Stoughton via email at firstname.lastname@example.org, or at Evergreen Spine & Sports Medicine 303-670-8902