Pain in the heel and/or bottom of the foot is a common complaint that we see here at the clinic. Often the pain is described as being at its worst when the person first gets up from sitting or lying down and after weight bearing. After a few steps, the pain usually goes away or diminishes greatly. This presentation of pain is very typical of Plantar Fasciitis.

The plantar fascia is a flat band of soft tissues that extends from the heel to the toes. The job of the plantar fascia is to support the medial longitudinal arch, the arch between the big toe and the inner heel. When the plantar fascia is strained, tight, or has tears of the fascial fibers, it gets inflamed and thus presents the typical symptoms of pain and inflammation. The usual course of treatment is to ice the area, taking anti-inflammatories, and perhaps be given a few stretches to do for the Achilles tendon or occasionally some rolling on the plantar fascia itself.

When we see patients here at the clinic, the pain is often greatly exacerbated and the usual course of treatment only temporarily relieves the symptoms. Like any chronic pain or pain that did not stem from an acute injury, Plantar Fasciitis cannot be cured and prevented by simply treating the area of the pain.

What Causes Plantar Fasciitis?

Plantar Fasciitis develops when there is a loss in strength of the muscles in the foot or lower leg. What predisposes these muscles to losing strength is generally alternations in movement mechanics of the entire lower limb, which then place undue stress on the arches. This could be due to poor posture, muscle imbalances and/or  alignment issues, all of which may change how the person’s body weight is distributed onto the feet. Changes in distribution may then cause the arches of the feet to change and increase the stress upon them. If the muscles can’t handle these changes, the plantar fascia then becomes more strained. Over time, this can cause tightness and/or tears in fascial fibers from accommodating the additional stress.

To treat Plantar Fasciitis, then, is not just a matter of settling the inflammation in the local area of the heel. It is imperative to look at the overall alignment of the body. As well, the individual’s body mechanics, such as in walking or running to ensure that there is proper alignment, muscle balance, and flexibility of the joints to ensure all are working in alignment and not putting undue strain on the feet.

For my patients, I will often ensure that they have proper pelvic mobility and stretch their entire back chain of soft tissues.

There are 2 typical exercises I give in order to assist with this. Click links for tutorials.

1. Pelvic tilts in sitting, keeping legs squeezing towards midline  https://www.youtube.com/watch?v=l5RRT_r6uO0

2. Downward Facing Dog https://www.youtube.com/watch?v=O9S37myB1Pw