Posted: April 2, 2003

Tracy Montgomery's Sports Injury & Treatment Column: Plantar Fasciitis

One of the most common causes of pain in the bottom of the foot is plantar fasciitis. The plantar fascia is a thick band of fibers which runs along the bottom of the foot, inserting at the heel (calcaneous) and extending to the balls of the foot (metatarsal heads). Plantar fasciitis is micro-tearing and inflammation of this band at its attachment to the heel.

The main symptom of plantar fasciitis is pain at the inner side of the bottom of the heel. Pain is usually most intense when first standing after any prolonged periods of rest. Symptoms gradually subside after several minutes of walking but often return with prolonged activity. Sufferers will usually have the most difficulty when first standing out of bed in the morning.

Causes of plantar fasciitis stem from poor foot mechanics and the inflexible nature of the plantar fascia. Because the plantar fascia contours the arch of the foot, each weight bearing step causes the plantar fascia to stretch. The plantar fascia does have a small allowance for stretch but excessive over-pronation (inward roll of the foot) overloads the stress on the plantar fascia. The fascia and the surrounding muscles tighten. The weakest point along the plantar fascia is where it inserts with the heel bone. This is where pain is felt due to micro-tearing and subsequent inflammation at the attachment. If left untreated, the body adapts by forming painful heel spurs.

When treating plantar fasciitis, two major factors need to be addressed - the tight tissues along the plantar aspect of the foot and the biomechanical dysfunction. Most conventional therapy only treats the site of inflammation. This may give short term relief of symptoms but does not address the causative factors (tight tissues and biomechanical dysfunction). Active Release Technique® (ART) has been proven to be one of the most effective ways of releasing tight tissues that lead to plantar fasciitis. Even in chronic cases of plantar fasciitis, ART is effective in relieving the pain. ART can be a permanent solution to the problem but plantar fasciitis may return if the biomechanical dysfunctions are not addressed. Improper foot mechanics can be corrected as easily as selecting the proper footwear or may require corrective orthotics.

Without treatment, the symptoms of plantar fasciitis rarely clear up on its own. However, here are a few suggested tips that may offer some relief:
-place feet directly into shoes for the first steps out of bed
-ice by rolling foot over a frozen water bottle after activity to reduce inflammation.
-minimize bare foot walking (i.e. Shoes around the house)
-emphasize stretching calves (lower limb fascia is continuous with plantar fascia)
-stretch plantar aspect of foot by rolling foot over a tennis ball
-self massage on plantar aspect of foot.

To find an ART provider in your area, check the locater at www.activerelease.com

Visit Tracy's web site at: www.montgomerymassage.com.