Plantar Fasciitis

It sucks

There is about a 10% change you will develop plantar fasciitis pain in your lifetime. Are you at risk? Want to know what causes plantar fasciitis pain? Here are 3 factors that put you at risk.

3 Risk Factors for Plantar Fasciitis Pain

1. Decreased Ankle ROM

2. On your feet all day

3. Obesity

#1 Decreased ankle motion can cause plantar fasciitis

Missing motion in the foot, especially dorsiflexion, can alter walking mechanics and cause extra stress to the plantar fascia. This is a classic “overuse” mechanism that can lead to pain.

This can also lead to reduce motion of the big toe and alter the Windlass Mechanism, which is 50% of the foots job.

Here’s a video on how to improve ankle and toe motion. The front foot is working dorsiflexion, the back foot toe extension.

#2 On your feet all day

Its easy to blame foot type (flat, arched, etc), but usually its TOTAL time on your feet, not your general foot shape.

foot type may change the treatment, but not the risks

#3 Obesity is a risk factor for plantar fasciitis

This may be the elephant in the room, but obesity increases your risk factor for plantar fasciitis (and MANY other issues) because

• Decreased healing ability because of full body inflammation

• The foot is working harder because of extra weight

• Low activity tolerance/general fitness

• Other co-morbidities you may have

If you are heavier and dealing with plantar fasciitis pain, be sure to only exercise to tolerance.

Pain during exercise is okay, general guidelines for pain during exercise are:

• don’t let pain exceed +2/10 of your baseline; meaning if baseline is 2/10, don’t let it EXCEED 4/10

• don’t let pain exceed 5/10 on an absolute scale

• pain should NOT be worse your next exercise session

Summarizing the causes of plantar fasciitis

Plantar fasciitis can be pretty painful. The treatment for this condition is “easy,” but managing the causes of plantar fasciitis can be a real challenge. Step 1 is knowing what your risk factors are, then working to reduce those factors. Learn how to treat plantar fasciitis

How Do You Fix Plantar Fasciitis?

• Strengthen the plantar fascia

• Restore blood flow

• Weigh less

• Dry needling/ injections

Strengthen The Plantar Fascia

All tissue, regardless of what type (bone, muscle, tendon, ligament) can be strengthened. This holds true for the plantar fascia as well. See video below. The big toe dictates how the foot functions a great deal.

• Allowing the big toe to extend during a calf raise ensures the plantar fascia is strengthened through its entire ROM

• Perform 3 sets of 15 reps in a double leg stance

• If this is easy then perform the same rep scheme in a single leg stance

• Progress by adding reps first and then weight

Restore Blood Flow To The Plantar Fascia

This can be accomplished by 3 different methods, all of which I have seen work well in real life application.

1. Scraping (Graston, IASTM)

2. Rolling with a lacrosse ball

3. Night splint

Scraping

• Scraping is a technique in which you apply a force to the tissue which in turn stimulates healing and blood flow

• Scrape the plantar fascia (bottom of foot) for 3-5 minutes a day

• Scraping is unpleasant in the moment but afterwards you will feel better

Rolling with a lacrosse ball

Night splint

• I see good results with a night splint on patients in the real world

• Wear this every night to keep the plantar fascia lengthened while you sleep

• See the image below for a quality night splint

  

Weigh Less

This is the part you may not want to hear but you need to. Don’t yell at me. This isn’t my fault

Having a BMI over 27 is the single best predictor for developing plantar fasciitis. Lose some weight and I guarantee your foot will feel better

There are plenty of other ways to exercise and burn calories. Getting foot pain every time you run is not a solution. If running is something you insist on, take a short break and find another cardio machine (bike, elliptical)

Dry Needling

Dry needling falls along the same concept as scraping from above. Small needles are put into the plantar fascia. These cause a small amount of trauma to which the body responds by increasing blood flow to increase healing.

The reason this is in this section is that a medical professional has to do this procedure.

Corticosteroid Injection

Corticosteroid injection is another alternative treatment for plantar fasciitis. However this should be the final measure taken. Although the injection has a good chance to decrease the pain, it increases the risk of plantar fascia rupture. This is only included as an education piece. I do not recommend this procedure.

Plantar fasciitis can be a very painful condition but this guide will fix that issue for you. It is not an overnight fix but the pain should resolve in a few days/weeks.

Hopefully you find this helpful. If you need more for plantar fasciitis, we have a complete guide available here.