Plantar Fasciitis 101

Updated: Apr 1, 2019


Dr. Christopher Dorsa, DC, CCSP


What is Plantar Fasciitis

Plantar fasciitis is inflammation of the fibrous material that connects the heel bone to the toes. The pain typically originates in front of the heal and can be recreated with pressure by the thumb. Symptoms are usually worse in the morning and start to feel better by the end of the day with movement and stretching.


Typical Cause

Plantar fasciitis is caused by overuse of the plantar fascia due to atrophy of supporting foot muscles. Plantar Fasciitis is primarily a first world problem due to the overuse of shoes and orthotics that provide too much support for the foot, causing atrophy and weakness of the foot muscles. This effect is similar to wearing a cast after breaking a bone, when the cast is removed there is noticeable atrophy due to disuse of muscles surrounding the immobilized joint.


Weaker foot muscles cause more strain into the fascia, which eventually will lead to pain. Fascia isn’t designed to withstand the weight of the entire body, it is designed to support the underlying muscle. Without the muscle support, the plantar fascia takes on more load, which translates into more strain into the surrounding joints, ultimately causing inflammation and pain.


How to solve it on your own

The ultimate solution to cure this pain is building up the muscles of the foot and arch so that the plantar fascia doesn’t have to work as hard. This entails lots of toe wiggling, foot crunching and balancing. One simple exercise is “towel grabs” – try picking up a towel with the toes of one foot and passing it to the opposite foot. Another motor control exercise is separating the big toes from the smaller toes in all directions. Or just simply not wearing shoes. The foot is designed for these activities but the skills may be lost after years of disuse. Foot movement may be painful and hard at first, so utilizing passive care modalities can help to symptoms in the process of building up your foot muscles.


When you might need extra help

Some muscle and ligament techniques are designed to relax the fascia thereby taking tension off of the foot, such as Graston Technique, acupuncture, dry needling, adjustments, and massage. Things like tape and certain orthotics can help to support the fascia allowing for movement with less pain, without restricting the foot’s natural motion. Laser therapy can help to decrease the localized inflammation which helps to alleviate pain as well as increase circulation and speed up the healing time of this injury. Combined with strengthening exercises these treatments can lead to complete resolution.


Conclusion

The cause of plantar fasciitis is disuse of the foot. Plantar fasciitis does not exist in countries that spend their time barefoot. However, shoes are generally necessary in U.S. society, so we need techniques to combat against disuse. This means arch exercise and barefoot when possible. When pain is so bad walking is not possible, seek palliative treatment to make your foot feel better while going through the rehab process.


Christopher Dorsa, DC, CCSP is a Certified Chiropractic Sports Physician. He is also certified in Active Release Techniques (ART) and Functional Range Conditioning (FRC). He is a certified personal trainer through NASM as well as a Kinstretch Coach. He integrates his training background into individualized care to provide the best form of treatment, rehab and education to facilitate healthy lifestyles and ultimately influence positive change in healthcare. Areas of special interest include shoulder and hip injuries, and performance mobility training.

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