Plantar Fasciitis Simplified

jakubowskiBy: Dr. Rachel Jakubowski
Physical Therapist

There are a few types of people I see with plantar fasciitis: The first group usually is middle-aged, likes to run recreationally, enjoys participating in marathons, and typically just started back up with running within the last few months to a year. They report pain near the heel on the bottom of the foot that started gradually and, at first, the pain would go away with a warm up or after a few minutes of running. But now, since they have let it linger for so long, they can’t run even a few feet without experiencing excruciating pain. The second group spends a lot of time on their feet during the day. They are walking or standing for prolonged hours, usually on hard floors. The last group of individuals with plantar fasciitis tend to be overweight on top of having to stand for prolonged periods of time. Each group will report experiencing foot stiffness in the morning upon rising from bed. They have tried icing it, massaging it, potentially a corticosteroid injection, but nothing has led to long term relief.

imgresWhat is plantar fasciitis:
• The plantar fascia is a thick band of fibrous tissue and serves as a bowstring to support and hold together the arch/bones of the foot. When the plantar fascia gets overworked from repetitive loading/pounding onto the foot from running, walking or purely from being overweight, the plantar fascia eventually gets inflamed and develops micro-tears.

What causes plantar fasciitis:
• Excessive pronation (feet roll inward too much when you walk)
• High arches or flat feet
• Walking, standing or running for long periods of time
• Being Overweight
• Wearing worn out or ill-fitting shoes
• Restricted ankle mobility
• Weak hip/core musculature
• Restricted first toe extension

Below is a condensed list treatments I have found to be effective. I pulled this information from research performed on plantar fasciitis as well as what I have learned from clinical observation in my own practice. The 1st course of action in treating plantar fasciitis includes limiting, or ideally, stopping activities that increase heel pain—i.e. running. Sorry I have to be the person to break the bad news but resting your feet from the pounding of running is important to let your plantar fascia heal.

Provides Temporary Relief:
• Self-Massage of the plantar fascia using a lacrosse ball, golf ball, or tennis ball
• Self-Massage using your hands
• Icing the plantar fascia
• Inserting heel lift or orthotic into your shoe
• Corticosteroid injection

Fixes the Problem:
• Change your running shoes—look for shoes that have an adequate amount of heel and arch support. A shoe that is too flexible can cause excessive strain placed on the plantar fascia
• Fix your hip mobility: do hamstring, quad, or hip internal/external stretches
• Strengthen your core/hip musculature
• Strengthen your foot musculature
• Improve your ankle dorsiflexion
• Maintain a healthy weight
• Improve first toe extension
• Strengthen the posterior tibialis

Things to avoid:
• Sandals
• High Heels
• Flexible Shoes

Self-Massage of the Plantar Fascia

1st Toe Extension Active Release Technique

Intrinsic Toe Muscular Re-education
Your small foot muscles that connect each toe together and support your arch need to be strong. The exercises in the video below are designed to not only wake the your foot muscles up but to also get them stronger.

Ankle Dorsiflexion Stretches

Calf and Hamstring Stretch (Inch Worms)

Try the exercises provided if you are suffering from plantar fasciitis and if you feel like you need extra help, feel free to call or email me at 321-218-0435, We do free 20 minute evaluations so take advantage of it!

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