Plantar fasciitis (PF) is one of the most common causes of heel pain. It affects both sedentary and athletic people. Classic symptoms include severe pain upon getting out of bed in the morning or after prolonged periods of rest. Pain usually improves with movement, but can get worse with long periods of standing.
What’s in a name? The plantar fascia is a thick fibrous band of tendons (technically not fascia) called aponeurosis that attaches at the inner heel, run along the bottom of the foot, and attaches at the base of the toes. While long thought to be a condition of acute inflammation, current thinking suggests that it is a chronic disease with evidence of tissue degeneration. Thus the term “plantar fasciosis” has been introduced. It is difficult to treat because of limited understanding of the mechanism by which the body heals chronic degeneration.
Anatomical risk factors include obesity, flat feet, high arches, and a shortened achilles tendon. Biomechanical risk factors are overpronation (inward roll of foot), limited ankle dorsiflexion (“flexing toes to shin), weak intrinsic muscles of the foot, weak plantar flexor muscles, and poor biomechanics & alignment. Environmental factors put us at risk too, such as deconditioning (being on bedrest or sedentary), hard surfaces, walking barefoot, prolonged weight bearing, inadequate stretching, and poor footwear.
I’ll focus on those biomechanical and environmental factors that can be addressed conservatively through yogasana, plantar fascia-specific stretching, alignment, and conditioning, aka FootLove Yoga.
FootLove Yoga and January’s Happy New Feet posts can help with:
- Overpronation of the foot – may be improved by the Strong Yoga Foot (upcoming blog post)
- Limited ankle dorsiflexion – may be improved by calf stretching (upcoming post)
- Weak intrinsic muscles of the foot and weak plantar flexor muscles – can be strengthened by many of the exercises I’ll be sharing in the coming weeks.
- Poor biomechanics (how you move) and alignment are two of three habits that have the most significant impact on the tissues & health of your feet – I will convey to you some fundamental changes you can make in how your move and align yourself that, overtime, could make a significant difference in your experience of PF.
- Poor footwear or, rather, poor shoe selection is the third of the three habits that impact your feet – Get ready for a post on this sensitive subject. I AM NOT THE SHOE POLICE. Well, kinda I am. I DO NOT HATE SHOES. Not that much really.
- Deconditioning of the foot, which may or may not be associated with overall deconditioning – everything we do in January will be with the aim of conditioning the feet.
- Hard surfaces & walking barefoot will be explicitly addressed as part of conditioning the feet.
- Prolonged weight bearing (which is a reality for many jobs) will be addressed with alignment. If you have to stand for long periods of time, there are ways to align and move yourself that will help.
- Inadequate stretching – many of the FootLove exercises will stretch intrinsic & extrinsic foot muscles, calves, and hamstrings.
Since plantar fascia-specific stretching has the best statistically significant long-term results as compared to other treatments like anti-inflammatories, corticosteroid injections, and most orthotics, let’s start with one of these evidence supported stretches.
Manual plantar fascia stretch with massage. Extend (stretch back) your toes with your hand and massage the plantar fascia crosswise. Stretch and massage your foot for a few minutes before taking your first steps after sleep or prolonged rest.
Some of the research I looked at.
Plantar Fasciitis: A Concise Review
Schwartz EN, Su J
Perm J. 2014 Winter;18(1):e105-7.
Cutts S, Obi N, Pasapula C, Chan W.
Ann R Coll Surg Engl. Nov 2012; 94(8): 539–542.