Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain in adults, accounting for one million patient visits a year to family doctors, orthopedists and general surgeons. The good news is that it’s almost always preventative and/or treatable with natural therapies you can do at home.
What is it?
Well, there is a thick band of tissue -- the plantar fascia -- that runs across the bottom of your foot, connecting your heel bone to your toes. When that thick band becomes inflamed, it causes a stabbing pain in the bottom of your foot near the heel. The pain is usually the worse with the first few steps in the morning. As you get up and move around, the pain normally decreases, but it might return after long periods of standing or after rising from sitting. And the pain can be worsened after exercise, rather than during it.
What Causes it?
Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot and bearing the weight of the body. If tension and stress on that bowstring become too great, the fascia can suffer tiny micro-tears. Repetitive stretching and tearing can cause the fascia to become irritated, inflamed and swollen. Though in many cases of plantar fasciitis, the cause isn't clear.
Plantar fasciitis is more common in runners. The pain may occur in one foot, in both feet at the same time, or can alternate side to side over time. In addition, people who are overweight and those who wear shoes with inadequate support have an increased risk of plantar fasciitis.
Are You at Risk?
Though plantar fasciitis can occur without an obvious cause, there are factors that can increase your risk of developing this painful condition, including: • Age. Plantar fasciitis is most common between the ages of 40 and 60. • Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue — long-distance running, jumping activities, ballet and aerobics — can contribute to the onset of plantar fasciitis. • Foot mechanics. Being flat-footed, having unbalanced arches, having a muscle imbalance in the legs or even having an abnormal pattern of walking or posture can affect the way weight is distributed when you're standing and put added stress on the plantar fascia. • Obesity. Excess pounds put extra stress on your plantar fascia. Every extra pound you’re carrying places four times that much weight on the feet and other weight bearing joints. • Occupations that keep you on your feet. Factory workers, teachers, retailers and others who spend most of their day walking or standing on hard surfaces can damage their plantar fascia.
What Can You Do?
1. Rest, ice and massage
You’ve got to take a break from the movements that trigger the condition and increase the pain. It’s likely you’ll need several weeks of rest to allow the affected area to heal properly, although the time needed varies from person to person.
Icing the area can be very helpful. Elevate the foot and apply an ice pack for 15-20 minutes, 2-4 times daily.
Once the swelling subsides (maybe 2-3 days), massage the heel and apply moist heat to further reduce inflammation. Try rubbing your thumb firmly over the arch of the affected foot from the ball back to the heel. If you can’t reach your toes, use a rolled towel or a roller to work the arches. Warm oil massages are extremely beneficial to increase the flood flow and speed up the healing process and break up scar tissue and adhesions that may harden. Use your hands in a circular motion for 15+ minutes and use coconut or olive oil. Use of a roller massage is a great option for any foot issues too. Simply roll your foot back and forth for relief.
2. Gentle Stretching and Exercise
Studies show that stretching exercises for the legs and affected heel are the most effective treatment option. Stretching the bottom of the foot as well as strengthening the calf and Achilles tendon improves form, muscle balance, range of motion and decreases pain.
The American Orthopedic Foot and Ankle Society and the Mayo Clinic recommend these simple home exercises (see picture diagram):
• Towel scrunches. Your toes try to scrunch up the towel underneath them, hold for 10 seconds and release, doing this 10 times. • Toe stretches. Take hold of toes and pull them backwards, holding for 10 seconds and release, doing this 10 times. (Can be done with towel if toes can’t be reached with fingers) • Standing tendon stretches. Leaning on the wall, front leg bent, back leg straight, heels down on floor. Hold for 10 seconds and switch legs, doing this 10 times.
3. Wear Supportive shoes
Avoid high heels. Wear shoes with low to moderate heel, good arch support and shock absorbency.
Don’t go barefoot especially on hard surfaces until you build your arch strength.
Don’t wear worn-out athletic shoes. If you are a runner, buy new shoes after about 500 miles to avoid injury.
Heel cups and orthotics can be useful support, fitted to your arches to distribute foot pressure more evenly.
4. Maintain a healthy weight
Reaching and maintaining a healthy weight can help minimize the amount of stress placed on your heels. Don’t forget to eat an anti-inflammatory diet (fruit, vegetables rich in magnesium and potassium, wild-caught fish, probiotic foods, nuts and healthy proteins), reduce stress, get enough sleep and exercise regularly.
Plantar fasciitis is often mistaken for heel spurs (presence of extra protrusion on the bony surface of the heel) as they share many of the same symptoms and causes. Both the damage to tissue done with plantar fasciitis and the bony deposits of heel spurs form in response to repetitive damage and strain on the heels. It’s even possible to have both plantar fasciitis and heel spurs at the same time. The good news is that the natural treatment of symptoms for both is the same.
Ignoring the pain of plantar fasciitis may result in long-term or even permanent damage. And, there’s a real danger that, in trying to minimize the pain, you might change the way you walk which could lead to foot, knee, hip or back problems.
Although plantar fasciitis can be very painful and disruptive to your lifestyle, it is mostly preventable and highly treatable with rest, icing, massage and targeted stretches and strengthening/balancing exercises. About 90% of sufferers improve significantly after a couple of months of this initial treatment, especially if they incorporate these other suggestions into their daily lifestyle. Only very rarely are last-resort interventions including medications or surgery needed.
Consider visiting a Chiropractor or Physical Therapist if the pain doesn’t subside. They can teach you how to perform heel exercises that stretch the plantar fascia as well as work with you to learn proper form when exercising. A professional can also help you learn how to strengthen your Achilles tendons, calves and lower leg muscles, along with your ankles and lower back, to align and stabilize your body weight over your heels better and avoid the vicious cycle leading to more tissue damage.
If you’re suffering with foot pain from plantar fasciitis and need a professional to guide you through these steps, or perhaps you’ve tried these suggestions and are still suffering, Dr. Allison is ready to drug-less-ly help you through consultation or his seminars. Give him a call.
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