"Plantar" is the anatomical term for the bottom of the foot, and fascia is connective tissue that provides support and structure throughout the body. Countless people learn more than they ever wanted to know about foot anatomy when they develop a painful inflammatory condition called plantar fasciitis. It's the "most common cause of foot pain in athletes," according to Fiona Rattray and Linda Ludwig in their definitive text "Clinical Massage Therapy." The condition doesn't only plague athletes, though. Plantar fasciitis affects many people who spend a lot of time on their feet or who are predisposed because of anatomical, age-related or other factors. Fortunately, some stretches and exercises can help you avoid the condition or manage the pain from the condition.
Facts
Plantar fascia is a tough sheet of connective tissue that runs from the Achilles tendon, over the back of the heel, and along the bottom of the foot. It supports the arch and acts like a shock absorber, helping the foot spring back to its normal shape after each step. Plantar fascia can become painfully inflamed, especially if it has extra strain from flat feet or high arches, excess body weight, pregnancy, tight calf muscles, or high-heeled shoes. Athletes risk inflaming their plantar fascia when they quickly increase their activity level. The pain primarily affects the bottom of the heel and the arch of the foot, and sufferers often say their feet hurt worst when they take their first few steps in the morning and after exercise or prolonged standing. The condition can take months to heal and some stubborn cases take much longer, leaving the sufferer to manage a chronically painful condition.
Stretching Exercises
Do good, deep calf stretches to take strain off of the plantar fascia. Lean against a wall, plant your foot and heel firmly on the ground behind you, and lean forward to feel the stretch. To stretch both major calf muscles, do this stretch with your knee mostly straight, and again with the knee bent. Stretch the plantar fascia the same way, by lifting your heel off the ground and rolling forward on the ball of the foot to lengthen the bottom of the foot. Plantar fascia is dense and tough, so for a safe and effective stretch, go gently and hold each stretch for 30 seconds or so.
Foot Strengthening Exercises
The deep intrinsic muscles that support the arch of the foot become weak and lazy over time. Strong, supple foot muscles can help support and stabilize the foot, leaving less work for the plantar fascia to do. Sit on the edge of a chair and place a bath towel or flat sheet of newspaper on the floor under your bare feet. Try to crumple up the towel or paper by moving your toes and arches in an inch-worm fashion. Rattray and Ludwig also suggest picking up pencils with your bare feet. Repeat until the muscles feel tired, and gradually lengthen your exercise time as your muscles gain strength and coordination.
Home Care
When plantar fasciitis is acutely painful, rest is the best treatment, but that isn't always possible for people who need to be on their feet for work. If you can't rest, protect your feet with supportive shoes, stand on a rubberized mat or other cushioned surface, and stretch whenever possible. Fascia injures more easily if it's cold and stiff, so take care to gently warm up your feet and calves before exercising or performing deep stretches. Manage inflammation by applying ice after work or exercise. Keep thick slippers or supportive slip-on shoes next to the bed to cushion those first few painful steps when getting out of bed. It's also helpful to wiggle the feet and do some gentle, warming foot and ankle movements before getting out of bed and putting your feet on the floor. The key point to remember is that sharp pain is a sign of re-injury, which will greatly slow your healing process, so try to avoid or minimize painful movements.
Medical Treatments
The American Academy of Family Physicians says some patients benefit from arch supports worn during the day and special splints worn at night. Some patients will need more treatment, which could include massage, physical therapy, or injections of anti-inflammatory drugs. The most stubborn cases sometimes require surgery.
References
- "Clinical Massage Therapy"; Fiona Rattray & Linda Ludwig; 2000
- American Academy of Family Physicians: Plantar Fasciitis
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