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SELF TREATMENT FOR PLANTAR FASCIITIS BY JESSE JAMES RETHERFORD

Over the past week, I have seen a “mini-epidemic” — two new clients and email correspondence with a third — of a common but painful foot injury, plantal fasciitis. Living in Austin, with such an active outdoors culture, plantar fasciitis is one of the more common issues I treat. It is also one of the most common foot injuries in the United States. As reported by Pubmed, two million Americans suffer from plantar fasciitis each year and 10% of the population over a lifetime.

Plantar fasciitis involves pain of the plantar fascia. The plantar fascia is a thick fibrous band of connective tissue located on the bottom of the foot. The plantar fascia attaches to the heel bone and extends along the sole of the foot towards the five toes. Its function is to help maintain the arch of the foot, and it acts as a powerful spring with a fundamental role in shock absorption and forward propulsion.

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Plantar fasciitis develops gradually and commonly starts as a dull, intermittent pain in the heel, mid-sole, or near the toes. The pain is worse early in the morning and tends to ease up once you move around a bit. When untreated it can progress to a sharp or stabbing pain. It may hurt when climbing stairs or after standing for long periods of time. It is common for someone with plantar fasciitis to also suffer from knee pain. Plantar fasciitis can become a chronic condition that plagues people for years.

Plantar fasciitis is caused by stress to the soft tissue that supports the arch of the foot. It is possible to develop plantar fasciitis from an acute injury, although it is far more commonly a result of repetitive trauma to the foot from walking or running with poor gait mechanics.

The arch of the foot acts like a shock-absorbing spring. With proper walking or running mechanics, the arch absorbs and releases the impact of each step, preventing damage to the knees and hips. The problem that most people have is that they heel strike, a dysfunctional gait pattern developed due to previous injury or poor shoe selection. When you heel strike, you bypass the natural spring of the arch, and the impact of each step is driven through your heel. This causes an ongoing series of micro traumas directly to the heel — where the plantar fascia attaches — and through the soft tissue of the knee and hip. The repeated stress and strain from each step you take can cause tiny tears in the ligaments and tendons and build restriction in the calf muscles.

Overweight individuals are more at risk of developing the condition due to the excess weight impacting on the foot.

Treatment
There is no one single treatment for plantar fasciitis that works for everybody. I have had great success using a few different treatments together. I see the best results — by far — with deep tissue massage therapy. On average it takes three or four massage sessions for a client to be pain free. When my clients do self-myofascial release, flexibility and corrective exercise, and buy new shoes, they generally are able to get back into the activities they love within a matter of weeks.

If you do not have access to a skilled deep tissue massage therapist, you can utilize the following tools to help bring relief, although it may take a few weeks longer to get to 100%.

Self Myofascial Release:

Following the directions in the pictures below, place your body weight on the foam roller or ball over taut bands of muscle tissue that need to be released. For the best results, begin near the center of the body and slowly work away from the center of the body.

Relax your body, breathe, and slowly roll through the length of the muscle. Your muscles will naturally tense up, especially when you hit a trigger point. Ease into it and allow yourself to relax.

If you find a painful spot, stop and visualize the soft tissue as melting butter and the foam roller as a hot knife. Allow pressure into the tissue and within 30-60 seconds you will notice a significant reduction in pain. Once the pain reduces (20-30%), move on to the next painful spot and repeat.

Spend between 3-5 minutes on each side. It is very important that you spend an equal amount of time on both sides and that you work through each of the areas listed to gain the most out of self-myofascial release.

Arch

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Use a small ball, such as a golf ball.

Calves

Place foam roller beneath calves. Slowly roll from the ankles to the knees

Turn your body to work the inside and outside of the calves.

Use a soft ball to perform self-trigger point therapy

Hips

Place roller length-wise to your body. Bend your knee to 90 degrees with your inner thigh on the roller.

Place roller beneath the top of the hip bone. Lie with one hip on the roller. Opposite hip is off the roller.

Sit on the roller. Turn your body to one side. Massage through the entire gluteal area from the crack of your butt to the outside of your hip, top of the pelvis to the top of the thigh.

Stretch calves using a foam wedge

Using a foam wedge, press heel into the ground and actively straighten your knee. Stretch to slight discomfort, NOT pain. Hold for 1-3 minutes each stretch

Using a foam wedge, press heel into the ground and bend knee down and forward. Stretch to slight discomfort, NOT pain. Hold for 1-3 minutes each stretch

Because the way you walk or run is a large contributing factor, changing your shoe selection and changing the way you walk and run are huge keys to fixing the problems that caused plantar fasciitis.

Read What Happens to Our Foot When We Wear Traditional Running Shoes by Dr. Nicholas Campitelli to learn more about how shoes change your gait.

SELF TREATMENT FOR PLANTAR FASCIITIS BY JESSE JAMES RETHERFORD

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