This hard-to-pronounce medical term simply means the soft tissues along the bottom of your foot are inflamed. The plantar fascia helps to support the arch of your foot. Typically, pain is felt on the underside of the heel or along the arch of the foot. Most people who have plantar fasciitis are frustrated because physical therapy has not helped cure it.
Here are steps that must be taken to cure plantar fasciitis:
- Teach patient to stand correctly without locking knees or bracing feet
- Apply manual therapy to stretch the deeper muscles of the calf
- Apply manual therapy to spread and soften connective tissues of calf
- Apply manual therapy to stretch plantar tendons of the foot and release the fascia bed surrounding the tendons. Eliminate fascia adhesions of the tendons.
- Apply joint mobilization to metatarsal joints and be sure there are no subluxations of the tarsal bones. The navicular bone is often out of place. Chiropractors and PTs can adjust the larger bones of feet and ankles.
- Patient must rest the feet for at least 3 days after treatment. No long walks or running for 3 days. If you stand at work, take 2 days off from work.
- Check footwear and be sure there is good arch support
- Check footwear and be sure the outsoles (bottoms) of the shoes are thick, resilient, not too hard and not slippery.
- Use a tennis ball once per week to stretch the plantar tendons. In a sitting position roll the bottom of your foot over the tennis ball while pressing down on the ball. Continue to 10 minutes.
Slow, prolonged, cross-fiber myofascial restoration must be given to the soft tissues of the foot and calf. Typically, the restoration will take about one hour per foot and calf. Few physical therapists are willing to do such manually intense work. You will need to find a myofascial therapist or orthopedic massage therapist you will restore the fascia for you.
Fascia restoration involves decompressing the fascia tissue. It is about spreading the myofascial tissue and thus creating space within the tissue. When you decompress the myofascia, you create better circulation of both blood and lymph fluids. And you improve capillary function so that more nutrients, oxygen and water reach the cells. Remember, the capillary beds are embedded in the fascia.The improved circulation helps all the tissues of the foot: nerve, fascia, muscle. Compressive force is taken off the nerves.
But there’s more that must be done to cure plantar fasciitis. Most people cause their own pain by standing in the wrong way. Many people press their feet hard against the ground. It’s like bracing yourself so you feel more secure. This behavior (like most habits) is not conscious…but you must become conscious of it. About 50% of person with plantar fasciits brace the feet and legs against the floor.
This behavior of bracing against the floor starts early in childhood. Children just imitate the movement and posture of the people who live with them. Persons who brace against the floor also may be locking their knees. This behavior is also common in children who had to take responsibility for themselves early in life. Children who push themselves to grow-up fast and catch-up to their older siblings might also show this behavior.
Try this now. Stand-up, place your hand against a table and push on it like you are trying to push it away. Feel how that makes all the muscles of your arm feel tense. Notice that the tension goes all the way up to the shoulder. If you have plantar fasciitis, it is likely that you push your feet against the ground and brace your legs tightly when you stand. The tension goes up the leg.
Have someone come up behind you and gently push the back of your knee when you are standing. If your knee does not bend with a light push from behind, you are bracing your legs and feet. You will never recover fully from plantar fasciitis until you stop this behavior.
Teach yourself to walk softly on the ground. Think about having a give and take relationship with the ground. In truth, yes in physics, your body both receives and gives energy to the ground. Try to become aware of this relationship.
Walk on the ground as if you expect it to support you. Walk as if you expect the universe, or a higher power to support you. Begin to explore ways that you can support yourself with love, respect, honor, courage, dignity, principles…so you no longer need to push against the ground to feel secure.
The combination of myofascial restoration to the feet and lower legs, along with correction of how you stand/walk on the ground will get you out of pain and achieve a cure for plantar fasciitis. We still need to discuss why it is so important to decompress the myofascial of the lower legs….it is not enough just to do manual therapy on the feet.
In cases of plantar fasciitis, the long, strong tendons along the bottom of the feet (the plantar surface) have become very hypertonic (rigidly tight).Your therapist needs to stretch these tendons, but that’s not enough. Tendons are connective tissue extensions off muscles. The long tendons of the foot are attaching calf muscles to the foot.
The number one reason most physical therapists and massage therapists fail to cure plantar fasciitis is that they fail to restore the fascia and stretch the deeper muscles of the calf.
The number two reason is that they fail to help the patient correct how weight is distributed through the feet and how the patient stands in relation to gravity.
