Plantar Fasciitis – What is it and Finding Relief

I frequently get questions about specific injuries. Many of these are about plantar fasciitis. Here is a breakdown of one of the more common causes of plantar fasciitis.

Picture of the achilles tendon wrapping around the calcaneus and blending into the plantar fascia. Plantar fasciitis.Plantar fasciitis is a pain symptom located at the heel or plantar fascia of the foot–the thick connective tissue which supports the arch of the foot. It is often most painful in the morning with the first steps out of bed, and may be aggravated by standing, walking, or running.

Here’s the deal about plantar fasciitis

It is the diagnosis of symptoms. It is not the diagnosis of the problem. The pain may be in your foot–but the problem is not. What you will not often find in definitions or explanations of plantar fasciitis on the web is that there is a deeper issue at play. The pain in your foot diagnosed as plantar fasciitis can often be traced back up to your gluteus maximus–your butt. These days, we sit too much and our butts muscles wind up not doing much. So they basically shut down or go to sleep–they become inhibited. This is not a good thing.

Your gluteal muscles have some very important functions. They are some of the most powerful muscles in the body and are the primary reason we stand upright. The gluteus maximus is a pelvic stabilizer and powerful hip extensor. The gluteus maximus provides power when we are going upstairs, rising from a sitting position, and climbing or running.

When gluteus maximus isn't functioning well, it get's very angry like the Hulk. This can lead to plantar fasciitis pain.Hip extension is your ability to stand upright. If you look at our primate cousins who still use their hands to walk, you’ll notice they have tiny butts. They also lack the ability to extend their hips into a fully upright standing position. Pelvic stability is hugely important. It provides the ability to stabilize the pelvis to our upper body, support the low back, and provide a solid powerful core. This point where your pelvis stabilizes with your upper body is where most coordinated movement is generated. If you lack pelvic stability, your entire movement system will be negatively affected. Your body demands stability. Without it, your body will find compensation elsewhere, by utilizing other muscles to do the job of those that are “sleeping,” i.e. inhibited. With plantar fasciitis, the calves are recruited to help stabilize the pelvis. This is not the work the calves are functioned to do. They don’t like it. Move like this long enough, and your calves will turn into The Incredible Hulk–they will get very angry and start to smash, i.e. tighten up and cause big hurt.

How this translates into pain in the foot

The two muscles that we call the calves (Gastrocnemius and Soleus) attach to the heel via the Achilles Tendon. The Achilles Tendon wraps over the heel bone where it then becomes the Plantar Fascia. The Plantar fascia stretches across the bottom of the foot to the base of your toes. While we may think of these muscles and tendons as separate plantar fasciitis is pain on the heel or plantar fascia of the foottissue structures, you can see by the picture that these structures are not separate. They are one continuous fascial tissue structure. So you can imagine that tension in one will affect each of the others. If your calves are working overtime–doing not only their job but also the job of your glutes–they may get distressed. With this distress, inflammation and pain will eventually set in. That pain can then show up anywhere in this continuous tissue chain. When the pain appears at the heel or plantar fascia, we call it plantar fasciitis. If it happens above the heel, it is called Achilles Tendonitis or tendonosis. The irony of all this is that the calves are not the issue! If anything, they are the most functional muscle in the group–they’re working overtime, after all. It’s their relationship with the asleep at the wheel Gluteals which need to be addressed. This is where the pain in your foot is literally a pain in the butt.

Relieving plantar fasciitis pain

GRIDXside
The Grid Foam Roller by Trigger Point Therapy

When treating any kind of painful dysfunction, my first goal as a movement specialist is to help my clients find relief from the pain. The method I’ve found most beneficial for this is self massage using The Grid foam roller to release the tension built up in the calves. Here are some simple exercises to help relieve the discomfort in your foot by working with The Grid.

Now once the pain is gone, this does not mean you are fixed. Pain is a communicator–it alerts us to an underlying problem. But it is not the problem itself. This is why the “treatments” often found online (such as this one) will only provide temporary relief; they target the symptom (pain) rather than the core underlying issue.

There is still movement dysfunction that needs to be assessed and addressed, and as detailed above, it likely originates in the hips. Strengthening and balancing movement patterns associated with the glutes is the next step in treating plantar fasciitis, and can best be done by making an appointment with a qualified movement specialist. To ignore this step places you at risk of an even more painful and serious injury at some point in the future. Finding help is hugely important in the long run for continued recovery and pain free movement.

Here are some simple quick tips for quick temporary relief. Or check out this older article with more exercises to help with plantar fasciitis pain.

Place foam roller beneath calves. Slowly roll from the ankles to the knees. Plantar fasciitis
Place The Grid foam roller beneath calves. Slowly roll from the ankles to the knees.
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 for plantar fasciitis
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
The Grid foam roller by Trigger Point Therapy. Self treatment for plantar fasciitis.
The Grid foam roller by Trigger Point Therapy.

 This is the foam roller I recommend: The Grid by Trigger Point Therapy

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Plantar Fasciitis Treatment for Fast Pain Relief

Image of plantar fasciitis pain on the bottom of the foot. Plantar fasciitis treatment

I originally wrote this article in 2011. Since then, I have expanded my knowledge and understanding of the underlying causes of plantar fasciitis as well as discovering a more solid plantar fasciitis treatment. The exercises I discuss here are still valid and many will find them a helpful plantar fasciitis treatment supplement. However, you will find the best plantar fasciitis treatment through the help of a highly skilled movement therapist who can assess the deeper movement dysfunctions that are causing the problem. I discuss this in more detail here.

What is Plantar Fasciitis

Over the past week, I have seen a “mini-epidemic”, plantar fasciitis, a common but painful foot injury. 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 are seeking plantar fasciitis treatment 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.
The three arches of the foot. Self treatment for plantar fasciitis.

Symptoms of Plantar Fasciitis?

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 plantar fasciitis 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, with millions of dollars spent on plantar fasciitis treatment. 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.Austin Barefoot Running, Austin deep tissue massage therapy, Austin running barefoot, barefoot running austin, barefoot runner 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 plantar fasciitis due to the excess weight impacting on the foot.

Plantar Fasciitis Treatment

GRIDXside
The Grid Foam Roller by Trigger Point Therapy

There is no one single plantar fasciitis treatment that works for everybody. I have had great success using a few different treatments together. I see the best results — by far — with the combination of a NeuroKinetic Therapy movement assessment and deep tissue massage therapy followed with a personalized exercise program. On average it takes three or four sessions for a client to be pain free.  When my clients do self massage using a foam roller, flexibility and corrective exercise, and buy different 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 Movement Therapist or deep tissue massage therapist, you can utilize the following self help tools for plantar fasciitis treatment, although it may take a few weeks longer to get to 100%.

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

Use a small ball, such as a golf ball to massage the plantar fascia of the foot. For plantar fasciitis treatment.

Calves

Place foam roller beneath calves. Slowly roll from the ankles to the knees. For plantar fasciitis treatment.

Turn your body to work the inside and outside of the calves. For plantar fasciitis treatment.

Use a soft ball to perform self-trigger point therapy. For plantar fasciitis treatment.

Hips

Place foam roller lengthwise to your body. Bend your knee to 90 degrees with your inner thigh on the foam roller. For plantar fasciitis treatment.

Place foam roller beneath the top of the hip bone. Lie with one hip on the roller. Opposite hip is off the foam roller. For plantar fasciitis treatment.

Sit on the foam 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. For plantar fasciitis treatment.

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. For plantar fasciitis treatment.

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. For plantar fasciitis treatment.

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.

The Grid foam roller by Trigger Point Therapy. Self treatment for plantar fasciitis.

 

This is the foam roller I recommend: The Grid by Trigger Point Therapy. This is an affiliate link. If you click it and make a purchase, The Art of Fitness will receive a small commission. These commissions help support TAO-Fit to continue producing life-changing content. Thank you for your support.

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