Plantar Fasciitis(PF) is a prime issue people come into our office looking to resolve. It’s such a simple problem with a rather simple solution. The solution takes work but is simple nonetheless. First off lets explore the plantar fascia and try to understand its purpose. This will give us a better idea of how it gets injured and how to rehab the area properly.
The plantar fascia has an embryological connection to the Achilles tendon which in turn arises from the gastrocnemius (calf muscles). The plantar fascia runs from the heel bone(calcaneus) and spans out like a fan to the bottom of all the metatarsals of the foot(the bones right before you get to the toes). The primary function of the plantar fascia is to help aid the arch of the foot when we stand, walk, run etc. It is mainly connective tissue, which means it has some stretch(elasticity) to it, but like all tissues, has its limiting range of motion, or its max stretch.
The biggest issue we encounter in the world of functional movement is that most people use a variety of “aids” that put their body at a disadvantage. The disadvantage that causes PF is that most shoes have heel lifts or other “support” that force our feet to work differently than they would when we are bare foot. These “supports” were meant to make movements like running and hiking easier for us, but in actuality, they end up making the foot a very passive part of the body. Passive in the sense that they make the feet rely on the shoe and support while typically atrophying certain muscles that give our foot rigidity and the ability to move properly.
Each foot has 26 bones, 33 joints and over 100 ligaments, tendons, and muscles. We always say in the office “There are no useless parts of the human body, just parts that we do not know what the use is”. Meaning you have every organ, muscle, tendon, cell for a reason. When you stop using a part of the body, whether its a brain cell or muscle in the foot, you LOSE it! We have to actively engage every part of the body in order to stay healthy. This is the same reason why functional exercises(exercises that use multiple joints of the body) are so efficient in building strong muscles.
Most of the shoes we use today are restricting our feet from proper mechanics by inhibiting certain muscles. For example, you have a set of muscles that primarily fan out(abduct) the toes a lot like the ones that allow you to spread out your hands. When you stuff your foot into a shoe with a narrow toe box( the toe box is the part of your shoes that cover the toes) then the foot is constantly being restricted from spreading the toes. After a number of blisters and sores from rubbing against the inside of the shoe, the brain recognizes that the activation of those toe abductor muscles is being met by an uncomfortable restriction. The brain is amazingly adaptive and will stop activating those muscles because the result is painful. Over time those muscles start to atrophy or breakdown, which is a common reason people get bunions at the base of the big toe.
Most people who suffer from bunions will have them shaved down at first. A bunion is a bone growth at the inside of the base of the big toe. Bone grows where there is stress and bone is very dynamic. When the muscle that brings the big toe towards the midline of the body atrophies, it creates a lot of stress over the outside of the joint causing bone to grow there to help stabilize the area. The most interesting fact about bunions is when most people get them shaved down, the bone regrows in that same area. Why? because shaving the bone growth doesn’t fix the CAUSE of the bone growth. The cause of the bone growth is the muscles have atrophied. Until the muscle tension in the foot changes, the bunion will continuously grow back.
Back to the topic at hand, When the muscles that are supposed to support the feet begin to atrophy, the foot loses its integrity. This is why some people’s feet grow a few sizes. Those intrinsic muscles of the foot help keep the foot in a particular position or posture. When the posture is lost the foot works more like a pile of puddy play doh instead of a strong, cohesive unit. The thing to keep in mind is although the foot gets wider and longer when the muscles atrophy, the plantar fascia doesn’t change its length.
Lets say the original length of the fascia is 10 inches. When the foot is 10 inches long then the fascia can cover that area comfortably. What happens when you have 10 inches of fascia to cover a newly expanded 12 inches of foot??
Extra stress is put on the plantar fascia causing inflammation around the area and thus: Plantar Fasciitis! Most people with PF go to their podiatrist, get an overly expensive set of foot orthotics and feel a little relief. Once they take their foot out of the shoe with the custom orthotic they typically feel the same amount of pain as when the issue first started. The real problem is NOT within the plantar fascia, it’s the lack of proper muscle activation of the foot. Special shoes and orthotics put your foot in that “perfect” posture but what happens when you don’t have the orthotic? Do you never walk barefoot again? The solution to the problem doesn’t lie within a shoe or shoe insert.
Then How do you solve the PROBLEM?”
When the foot regains the appropriate muscle strength, integrity is regained and that 12in foot goes back to being 10in and the stress is taken off the plantar fascia. For more info on how to regain that strength, contact us for our foot exercise protocol. We’ve helped many people regain the ability to walk comfortably using only NON invasive treatment of the neurological system as well as the musculo-skeletal system. Visit us athttp://www.functionalhealthspecialists.com or call us (925) 289-8011 to see if we can help.
The 1st step- Muscle work for the foot muscles is crucial. This can be done easily with a golf ball or tennis ball.
2. Use more flexible shoes- the more flexible the shoe the more you have to rely on building the muscles of the feet. This is a BIG transition so make sure you have your chiropractor on hand to help with any adjusting the feet will need through out this transition.
3. Controlled toe raises, shortfoot exercises and other foot exercises will also help build those atrophied muscles.