Plantar Fasciitis

Body Health Blog

As Vancouver's Sports Chiropractor, Armitage & Associates is committed to helping you maximize your performance potential. These articles are provided to help you understand muscle and joint behavior, prevent injury, and aid recover from common activity-related injuries.



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Plantar Fasciitis

Plantar Fasciitis involves the thick, fibrous tissue that runs from the heel to the base of the toes on the bottom of the foot called the plantar fascia. Discomfort and pain are usually worse first thing in the morning and most people describe the symptoms as if the bone at the base of the heel is bruised.

The injury results when the fascia is over stressed or stretched and, in some cases, actually tears. Inflammation then affects the fascia and surrounding tissues. Any tears are soon covered with scar tissue, which is less flexible than the fascia and only aggravates the problem.

Potential Causes

The most frequent cause of plantar fasciitis is the progressive tightening and shortening of the calve muscles in reaction to the workload of running. A common mistake of beginning runners is the absence of a regular and complete stretching program for the lower limb when taking on running as an activity or as experienced runners increase their mileage or speed. The shortening of the calf muscles causes a decrease in the stance phase of the running gait. As a result, early heel lift occurs and increase the amount and duration of stress placed on the plantar fascia causing it to over load and tear.

Potential Causes

  • Tight calve muscles or Achilles tendon
  • High arches and rigid feet
  • Flat feet that over-pronate
  • Immobile big toe
  • Worn out shoes

Treatment

Often a runner will change stride to alleviate the pain but this only provides temporary relief as the condition becomes more chronic. If it does not respond, then re-establishing normal joint mobility with manipulation and mobilization, friction massage (fascial release), Graston and/or ultrasound are next on the list depending on the advice of your sport medicine specialist. Surgery to detach the fascia from its insertion may be recommended if conservative medical treatments don’t have an affect. A bone spur may also develop at the heel where the fascia has started to tear away.

All of the above treatment methods are provided and available at Armitage & Associates Chiropractic Group.

Prevention and Rehabilitation

  • Stretch and strengthen muscles of the posterior compartment of the leg.
  • Strengthen the intrinsic muscles of the foot by picking up marbles or golf balls with your toes.
  • Orthotics may be the answer depending on your foot plant.
  • Run on softer surfaces.

There are two main stretches for the back of the calf. The first layer of muscle, also called the superficial layer, is comprised of the gastrocnemius, soleus and plantaris muscles. The deep layer of muscle includes the popliteus, flexor hallicus longus, flexor digitorum longus, and tibialis posterior. The gastrocnemius muscle crosses the knee and ankle, the soleus muscle only crosses the ankle and the deep layer cross the ankle and attach in the plantar aspect of the foot. Therefore, there are various ways to stretch the calf.

The first stretch is for the superficial layer. For the Gastrocnemius, stand near a wall that offers stable support and rest your hands or forearms on the wall. Place the leg you would like to stretch straight behind you keeping your heel on the floor. In this position push the back of your knee towards the roof while maintaining heel contact. For the soleus muscle position yourself against a stable surface as above and bend the knee of the leg you are stretching.

The deep layer can be stretched by supporting your forearms on a stable wall, prop your forefoot on a wall or a stepper and bend your knee. Aim to get you knee towards the wall.

Hold these stretches for 30–60 seconds, and then relax. Repeat using the opposite leg.

Photos:
sportsinjuryclinic.net, joint-pain-solutions.com,jointhealth.com.au

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