Understanding Plantar Fasciitis

By: Erin Ziprick, RMT

As the summer months come closer and the temperature warms up, people are generally more eager to get outside and start their summer activities. Along with those activities common overuse injuries may come up if the person isn't prepared or educated. One of the most common causes of foot pain in athletes is plantar fasciitis.

Plantar fasciitis is an overuse condition resulting in inflammation of the plantar fascia. (Rattray) It can result in tissue fatigue and micro tearing at the calcaneal (heel) attachment.

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“The plantar fascia is a thick, fibrous band of connective tissue. Its origin is the medial plantar tubercle of the calcaneum. It runs along the sole of the foot like a fan, being attached at its other end to the base of each of the toes. It is a tough, resilient structure that has a number of critical functions during running and walking:

* It stabilizes the metatarsal joints during impact with the ground.
* It acts as a shock absorber for the entire leg.
* It forms the longitudinal arch of the foot and helps to lift the arch to prepare it for the 'take-off' phase of the gait cycle.”

Research shows that plantar fasciitis “may account for as much as 8% of all running-related injuries [3 4]. The life time prevalence may be as high as 10% which means that quite a big proportion of us will at some point be affected by plantar fasciitis or see these patients in the clinic.”

Treatment:
One of the best ways to start treatment for planar fasciitis is to cease from the activity that is causing the pain, albeit running, jogging, cycling, climbing, or aerobics. Footwear should be such that gives more support even though it may be stiffer. Arch supports, orthotics, can also help reduce the pain, and it is said that stretching the calf muscles also affords some relief. Icing the area for about 15 minutes every day can also help. Once initial recovery is made, patients should consider a more aggressive form of treatment such as deep tissue massage.

Deep tissue massage is applied by using deep finger pressure on the fascia, Achilles heel, and calf muscles through slow strokes. The muscle fibers can be followed or pressure can be applied across tendons. Deep tissue massage can help to release the muscle tension, break scar tissue, and lead to its elimination. The massage therapist will concentrate on specific areas, and it is likely that the patient may feel some soreness before and after the massage.

Stretches: STANDING CALF STRETCH - GASTROCNEMIUS

While standing and leaning against a wall, place one foot back behind you and bend the front knee until a gentle stretch is felt on the back of the lower leg.

Your back knee should be straight the entire time.

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STANDING CALF STRETCH - SOLEUS

While standing and leaning against a wall, place one foot back behind you and bend the front knee until a gentle stretch is felt on the back of the lower leg.

Your back knee should be bent the entire time. Hold each stretch for 15-30 seconds and you can perform this throughout the day.

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Hydrotherapy: Another effective way to help decrease inflammation of the plantar fascia is to apply hydrotherapy.

FREEZE A PLASTIC WATER BOTTLE:
Taking the frozen water bottle out of the freezer and begin to roll the bottle on the bottom of your foot. The ice in the bottle will help decrease inflammation of the foot and providing relief. Be careful to not over-ice the injury to avoid any tissue damage. Perform this no more then 15 minutes at a time.

With appropriate rest and a combination of both remedial exercise and massage therapy, you will be back on your feet. For more information on a treatment plan, consult your massage therapist or local chiropractic clinic.

References:
* http://www.patient.co.uk/doctor/plantar-fasciitis - (03/15/15)
* http://blogs.bmj.com/bjsm/2014/09/15/plantar-fasciitis-important-new-research-by-michael-rathleff/ - (03/15/15)
* Rattray, Fiona. (March 2000). Clinical Massage Therapy. Elora, Ontario: Talus Incorporated.

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