Do you have a sharp pain in your heel when you step out of bed in the morning? How about pain in your heel when standing for long periods of time? Well, those may be early signs of plantarfasciitis.
So what is this plantarfasciitis, and why could this be happening? Plantarfasciitis is more common than you think. The group that is mostly affected is men between the ages of 40-60 and it is one of the most common orthopedic problems of the foot. In my years of PT practice, this injury has not been limited to this age group, as I have seen this diagnosis in many women and men varying in age. The onset of plantarfasciitis can be gradual. I recommend catching it early!
Let’s get oriented to the foot and understand where the plantar fascia is located and what its purpose is. The plantarfascia is a thick band of fibrous connective tissue that spans from your calcaneus (heel bone) to the base of your toes. The major purposes of the plantarfascia are to provide arch support for the foot during the gait cycle and to contribute to the “windlass mechanism.” The windlass mechanism principle can be described as when the plantar fascia acts as a tie-rod when tension increases as the foot is loaded through the gait cycle. During the propulsion phase of gait, the foot and big toe dorsiflex, and the plantarfascia will wind around the metatarsal heads (toes), decreasing the distance of calcaneus to metatarsals, increasing the arch height. The plantarfascia acts as the windlass because it simulates a cable attached to the calcaneus and metatarsal joints. When you bear weight on your leg, forces from your body flatten your arch, as the ground forces push up, contributing to more flattening of the arch. The plantarfascia will prevent the flattening and will maintain the arch. Think about what happens if you have an exaggerated arch (flat or high), or maybe even a weak arch, and you do repetitive shortening of the arch with running or walking - this could possibly lead to overuse and inflammation of the plantar fascia.
A. Dorsiflexion of the toes effecting the arch
B. Windlass Mechanism
Source: http://en.wikipedia.org/wiki/Plantar_fascia, Nov. 2011
Plantarfasciitis is an inflammatory process at the plantar fascia. A heel spur (small bone formation located on the inferior aspect of the calcaneus) can form if the plantarfasciitis is not addressed over a period of time. The reason for this pain in the bottom of your foot could be due to wearing poor shoes with minimal arch support. This can be the case especially around the change of seasons when you may change your foot wear. Another reason for this nagging heel pain could be due to your foot type. Do you have a high arch, or flat foot? Exaggerated foot biomechanics can lead to the plantar fascia being overstressed. Other common causes of plantarfasciitis can be sudden weight gain, increased running routine, and prolonged standing activities.
If you believe that you might have plantarfasciitis please consult your physician. Physical therapy can significantly help relieve irritation at the plantar fascia. Physical therapists may use, not limited to, deep tissue mobilizations of the plantar fascia and gastrocnemius/soleus, mobilizations of the ankle/foot joints, stability and proprioceptive exercises, general lower extremity strengthening, modalities like ultrasound and ice, orthotics, home exercise program and Kinesiotape to help assist with the healing process.
Please contact Jaime Herrmann, MPT, CSCS at Jaime@JointVenturesPT.com, if you would like more information and/or to set up a complimentary injury screen.