Plantar fasciitis hurts. It is a very common cause of foot pain and if you’ve had it, you’d know. The plantar fascia lies on the bottom surface of the foot and is a thick band of connective tissue that extends from the heel bone up to the base of the toes. It supports the longitudinal arch of the foot and helps create a more rigid foot for the toe-off phase of gait. If it does not function properly, the foot is allowed to roll inwards (overpronate) and can further irritate it and/or cause problems in the knees, hips or low back. Conversely, it can also be caused by a foot whose bones are not mobile enough. The plantar fascia tends to become inflamed with overuse and will create pain at its origin on the heel or into the arch, as well. As we age, with years of being weight-bearing on our feet, the stabilizing ligaments can become loosened and stresses are then passed onto the plantar fascia which copes as well as it can, but eventually gets inflamed and causes pain.
Victims of the condition typically report their pain is worst in the morning (or anytime after no prolonged weight-bearing) with the first several steps, but then gradually subsides. A patient one time described it to me as, “walking on razor blades.”
Treatment involves having one’s gait assessed and any biomechanical dysfunctions corrected, i.e. prescription orthotics. Hands-on work, such as massage therapy, active release, or instrument-assisted soft tissue mobilization of not only the plantar fascia itself, but the calf muscles too, is imperative. Assessment of the individual foot joint’s mobility is also important. Kinesiology tape can be of great help in taking strain off the plantar fascia and as far as home-care goes, rest, local icing, strengthening of the foot muscles and the “Strassburg sock” can be of help. This sock is worn at night and holds the calf in a stretched position which puts tension on the plantar fascia so it heals in that position. Once feeling better it is a good idea to stretch the calves, maintain the foot exercises and use the orthotics religiously, if they had been prescribed. The condition can wax and wane for several months, but with due diligence, will subside in time.
Dr. Mark Strudwick is a third-generation chiropractor in Victoria, B.C.