One of the worst ways to start your day is to feel a sharp, stabbing pain near your heel when first getting out of bed. Yet, approximately 3 million Americans every year experience this sensation with a condition called plantar fasciitis.
Plantar fasciitis is the inflammation of the thick band of tissue that runs along the bottom of your foot. The cause of this pain is attributed to small tears in the thick band, and it’s for this reason that many of the treatment options are focused on the foot.
So what is the plantar fascia and what is it for? What causes it to tear? And what can be done to treat the pain?
What is the Plantar Fascia?
The plantar fascia is a dense connective tissue that connects your heel to your toes, which serves to support the arch of your foot. It functions like a bowstring, undergoing tension when the foot bears the weight of the body. This mechanism acts as a shock absorber and provides support to the foot when we are upright.
When the plantar fascia is overloaded it can lead to small tears that are associated with plantar fasciitis. The damage to the tissue causes inflammation and contributes to pain and stiffness that’s most noticeable when standing up at the beginning of the day and when standing for long periods of time.
What Causes Plantar Fasciitis?
There are a number of commonly proposed explanations as to why plantar fasciitis occurs. However, we should be willing to question these causes as they don’t always make logical sense.
One of the most common explanations for the cause of plantar fasciitis is having either high arches or very flat feet. This is the reason why foot supports and orthotics are often suggested as part of treatment.
However, it doesn’t make much sense that both foot structures would contribute to the same outcome as a high arch is the exact opposite of a flat foot. Therefore, there must be a better reason for the onset of symptoms.
But while the amount of weight that is supported by the foot can certainly impact the load on the plantar fascia, not all overweight people experience plantar fasciitis. Also, plantar fasciitis can be experienced by those with normal weights as well so weight alone can’t explain the pain.
Excessive Time on Feet
The last reason that is thought to lead to the onset of plantar fasciitis is spending too much time on your feet. It is for this reason that professionals who stand and walk for work, as well as long distance runners, are more susceptible to this condition. Though this can be true, again, many can spend countless hours on their feet without experiencing this condition.
Perhaps the cause of plantar fasciitis doesn’t have to do with how much time you spend on your feet but rather how you are using your feet that leads to pain. For this reason, another cause should be suspected as contributing to plantar fasciitis — compensation in the body.
Compensation Causing Tissue Overload
As mentioned earlier, the plantar fascia functions to support the arch of the foot and is designed to tolerate the weight of the body. But like any other tissue, it will fail when overloaded beyond its design.
One of the main reasons for tissue overload is compensation.
There are two types of compensation that are generally involved:
1. Unequal Weight-Bearing
When weight-bearing we should be placing an equal amount of weight between left and right feet. This arrangement is not only the most stable but also puts an equal demand on each foot. It’s when we favor one side because of weakness that the other has to take on the additional workload. It’s not uncommon, then, that pain often occurs on the overcompensating side.
2. Reduced Hip Muscle Function
The hip muscles should contribute most to standing as they are the largest muscles in the lower body. In comparison, the foot muscles are quite small and not designed to contribute as much. However, if the hip muscles are deconditioned and weak, the foot muscles will attempt to overcompensate for this loss of function. This can easily overwhelm the tissues of the foot, including the plantar fascia, when tasked with supporting the weight of the entire body.
Treating Plantar Fasciitis
If you spend time searching the internet for the treatment options for plantar fasciitis, you’ll find a long list of remedies that usually includes the following:
- Orthotics and shoe inserts
- Weight loss
- Night splints
While these treatments can help in the short-term to reduce pain, they don’t address the tissue overload that’s occurring because of compensation. Therefore, it’s a good idea to include a treatment plan that involves resolving the compensation that’s often the source of plantar fasciitis.
The following exercises help to address your left-right imbalances and improve the function of your hips. Though these alone will not help to resolve plantar fasciitis they are a good place to start to resolve any compensation that may be occurring in your body.
Knee Block Squeezes
Place a block between your knees so that they are hip-width apart. Place your feet hip-width apart with your feet facing forward. Squeeze the block and release without dropping the block. Repeat 1 minute.
With knees bent bring your knees and feet next to each other. Let your knees spread apart and roll to the outside of your feet while balancing on your tailbone (sacrum) and keeping your back relaxed. Bring your knees back together. Repeat 1 minute.
Knee Strap Presses
Place a strap around your thighs so that your knees and feet are hip-width apart. Staying balanced on your tailbone (sacrum) press outward on the strap then release slightly maintaining some tension on the strap at all times. Try not to let your legs wobble. Repeat 1 minute.
Wide Active Twist
Start with your knees bent and feet wider than your mat, then place your arms straight out on the floor in a “T” position. Lower both knees to the left, try to bring them as close to the floor as you can. Release and slowly move to the right, moving as smoothly as possible. Repeat back and forth 2 minutes.
Alternating Hip Flexor Lifts
Start with your knees bent and feet hip-width apart. Lift your foot about 2–3 inches off the floor, keeping your lower leg relaxed. Do not push off with your foot. Keep your pelvis from rocking from side to side when lifting your foot. Alternate back and forth between your right and left side. Repeat 2 minutes.
Leg Press Glute Squeezes
With your knees bent and feet hip-width apart, straighten out your right leg making sure your right knee cap is facing the ceiling. Pull your right toes up to your shin and gently press the back of your right thigh and heel down into the mat. Keeping your leg that way squeeze and relax the right buttock. Repeat 1 min then switch sides.
Lie on your left side with your knees bent and shins stacked. While keeping the knees together, slowly turn your right thigh inwards to raise the right foot. Slowly lower and repeat for 1 minute. Switch sides.
Lie on your left side with your knees bent and shins stacked. While keeping your feet together, slowly raise your right knee. Make certain that you don’t roll backwards as you do. Slowly lower and repeat for 1 minute. Switch sides.
Prone Heel Press
Lie on your stomach with the soles of your feet together, knees wide as the mat and shins vertical. Begin by pressing the front of your hips down into the floor. As you do press your heels together and then slowly release. Repeat for 1 minute.
So how did it go? Did you discover any left-right imbalances or hip weaknesses that you weren’t previously aware of? Share your comments in the section below.