Thursday, May 01, 2008

Plantar Fasciitis Part I


Raina and several other readers asked about plantar fasciitis.

On a house, a fascia is a flat horizontal surface just under the roof. In your body, a fascia is flat fibrous tissue that wraps your muscles and soft structures. You have fascia in several places. One is across the bottom of your feet. "Plantar” means the bottom of your foot that you "plant" on the ground. Your plantar fascia is the fascia on the bottom of your foot. Plantar fasciitis is an inflammation (-itis) of the fascia on the bottom of your foot.

Normal Plantar Fascia Action
When you walk or run with your feet facing straight ahead, the line of bending of the foot is straight from front to back. Each step gives you a nice, built-in small stretch across the bottom of your foot. As you walk, run, jump, and move, your plantar fascia transmits body weight across your foot. It is part of shock absorption for your entire leg.

How Bad Movement Mechanics Hurts
Several things can make the fascia tighten and hurt. Here are three. More to come in future posts:
1. When you walk or run with feet facing outward, the fascia loses the normal stretch. Over years of not getting its normal stretch, it becomes tight. Walking with feet facing outward also puts sideways forces on the fascia with each step instead of the needed stretch. Walking with poor shock absorption, banging down heavily with each step can amplify strain forces on a tight fascia. Every step you take on a tight fascia yanks on the heel where it attaches. Eventually the heel and bottom of the foot get irritated from the yanking and start to hurt. Irritation can eventually cause the bone to thicken to protect itself - a heel spur.

The tighter your Achilles and foot fascia, the more "normal" it feels to walk toe-out. In a circular problem, walking toe-outward is a common fascial tightener. It may be "natural" with tightness, but can increase tightness over time.

2. Letting ankles constantly sag into pronation (flattened arches) is another fascial strain. Keeping body weight more evenly around the sole of your foot, not pressing and downward on your arches, lifts the weight off the arch. Reader David from Belgium made us a great short video of easily changing from rolling in on the arches to holding straight in Fast Fitness - Fix Flat Feet, Pronation, and Fallen Arches.

3. Hard sole shoes and some fasciitis braces stop the sole from getting the normal lengthening while walking, stopping the pain from the stretch, giving the false impression that the injury is lessening. A negative cycle continues of shortening and continuing the source of the injury. Injections briefly make the area more prone to injury. Pain pills allow you to continue the injury process without pain telling you that it is wrong. Several kinds of anti-inflammatory and pain medicines interfere with healing. Wearing high heeled shoes raises the heel, shortening the length of the Achilles tendon, putting less stretch on the tendon, the lower leg muscles, and the fascia of the foot.
Fasciitis can be quickly stopped. It does not have to be chronic. "Doing" a few stretches does not undo a lifestyle of shortening, tightening, and straining. Forcing tight, artificially straight position instead of creating the length and use of the area that allows healthful motion, can create more pain in other segments. Use your brain and learn good body movement to allow it to heal and be functional.

Helpful links to move in healthy ways to stop plantar fasciitis:

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4 comments:

  1. Seldom do I have problems with my plantar fascia, so I assume I'm positioning my feet properly when I walk. But I'm curious why I get inflammation type hip pain when I wear a particular pair of rubber boots I own. After several hours of wear my hip joints just ache horribly. (I only wear them when it rains). I thought it was because the boot's foot bed is very flat and there is no support for the arch.
    I've always tried to walk lightly and not pound on my feet when I walk. Why would my hips hurt and not my knees? I know I have a tendency to brace myself and shift my weight from one side to the other to alleviate pain from my upper back. Could the problem be uneven weight distribution on my feet?

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  2. I never had foot problems until I read an article that said George Bush runs like a duck-feet turned out as you also mention as a no no. Anyway I tried to consciously turn my feet straight when I ran. Eventually I started getting various pains in my foot, peroneal tendonitis, extensor pain etc.. I'm currently going to a PT who said that how your feet align is determined by the angle your leg attaches to your hip. If you are in retroversion as I am, your feet are going to turn out to some degree and there is not a whole lot you can do about it. Does anyone disagree?

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  3. Bob, "turn-out" can come from the ankle, knee, and/or hip, not only the hip. Yanking or forcing one segment straight without seeing the reason for the turnout is not usually a healthful solution. There are various reasons for "retroversion" and not all are set in the bone, but can be tight muscles. This can be evaluated and addressed in person by someone who understands the variables.

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  4. I also noticed that I had my right feet turning out a lot. I have been paying attention with how I stand and my gait. But some days I feel like I am fighting it all the way in to the hips. Especially when I have had to sit for a while. I have been getting massages that really help. I had previously stated in one of my post that it was trigger point but I was mistaken. It is more of a deep tissue with stretching.My hip was so twisted. Could that be giving me the shooting pain that run down my groin? I can actually put my hand on the spot. It is between the sacrum, tip of coxcyx and my sit bones. I was wondering if there were any stretches that you suggest for that. Lying on the floor and bringing the affected side knee into opposite chest is also a big releif. When it is flaring up the two movements that seems to make it worse is any adductor stretches and extensions lifting the legs up behind me. Do I have to work on my alighnment first and then do the extensions? I feel I am finally getting to the bottom of this injury. Thanks Doctor Jolie

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