Overview of Plantar Fasciitis

Plantar Fasciitis is one of the most commonly misunderstood and mistreated foot conditions because the medical definition is confusing, traditional treatments focus on symptoms and the exercises are typically physiologically incorrect, incomplete and ineffective.

Understanding the Definition of Plantar Fasciitis

Medical (symptom) definition

This definition is from the Mayo clinic.

Plantar fasciitis is inflammation involving the plantar fascia especially in the area of its attachment to the calcaneus (heel bone) and causing pain in the heel.

Unfortunately, there are several major problems with defining Plantar Fasciitis this way.

Plantar Fasciitis Pain Areas

Reasons why the medical definition is incorrect

  • Inflammation and pain are symptoms.
    • Symptom = a sign, condition, by-product or temporary event which often appears to be a problem. However, when remedied, the problem (pain) reappears with other symptoms. Symptoms need to be addressed, however, they should also be used to identify the most probable cause and your individual contributing factors.
    • Cause = the root of the problem. The reason for which something has undergone change and is now causing a problem.
  • Technically they are referring to the plantar aponeurosis not the plantar fascia.
    • Plantar = bottom
    • Aponeurosis = a flat sheet of tough ligament/tendon like tissue that mainly serves to connect the toe and heel bones.
    • Fascia = skin like tissue that envelopes muscle
    • Ligament = strong cords of tissue that connect bone to bone
    • Isis = inflation
  • There are four muscles/tendons (please refer to anatomy pictures) that also attach to your heel bone and any or all may contribute to plantar fasciitis:
    • The flexor digitorum brevis muscles/tendons
      • Flexor = pull down
      • Digitorum = the second to fifth toes
      • Brevis = the muscle and tendon are both located entirely within the feet.
    • The abductor hallucis muscles/tendons
      • Abductor = pull out
      • Hallucis = bit toe
    • The abductor digiti minimi muscles/tendons
      • Digiti = toe
      • Minimi = smallest
    • The gastrocnemius, soleus muscles/achilles tendons

The physiological (cause) definition

Plantar fasciitis is a repetitive strain injury involving foot and leg muscles, tendons, ligaments and the bones they attach to.

It is typically characterized by muscle imbalances where one or more flexor muscle/tendons are short/tight and one or more opposing extensor muscles/tendons are weak.

Foot Trainer Exercises and the rehabilitation products we recommend address the physiological cause by stopping the repetitive injury cycle, relaxing short/tight flexor muscles/tendons and strengthening weak extensor muscles.

The plantar fasciitis injury sequence

  • Repetitive impact on your feet and legs over time causes your flexor muscles/tendons to become short and tight.
  • Repetitive impact on short, tight muscles/tendons causes micro tearing at the point where your tendons attach to your heel and toe bones.
  • Repetitive micro tearing at the point of attachment causes progressive scarring of tissue, inflammation and pain.
  • Over a period of time heel spurs and arthritis may develop.

Factors Which Contribute to Plantar Fasciitis

To end plantar fasciitis pain you must address the cause and your contributing factors. The following are some of the most common contributing factors and information you can use to address them.

Symptom of another health disorder

Foot pain may be a symptom of a more serious health disorder in another part of your body. This is why a complete medical examination and diagnosis by your family doctor is recommended before starting any treatments. Please refer to "Whom to See".

Repetitively loading cold weight bearing muscles after long periods of inactivity

The classic symptom of pain or stiffness with the first step out of bed is caused by loading cold weight bearing muscles. Foot Trainer exercises are performed in your bed and will stop this re-injury cycle.

Neglect

"Use them or lose them " may be a cliché but it is true. Foot and leg extensor muscles are probably the most neglected muscles in our bodies because we take them for granted and many of the traditional exercises ignore them. Foot Trainer Exercises allow you the ability to perform safe, complete and effective exercises that target neglected extensor muscles.

Constant and over use

Your weight bearing flexor muscles are among the most constantly used muscles in the body. When they become injured it is difficult to rest them properly. Occupations or activities that require long periods of standing, walking, running or a sudden increase or change in the duration or intensity places tremendous amounts of force on them. Stronger more flexible muscles can help handle constant and over use.

Age

The natural aging process (sarcopenia) that leads to a gradual loss of muscle mass throughout your body starts at age 30. By age 50 the average person will lose 30% of their muscle mass and 10 % every decade thereafter. It is not surprising that plantar fasciitis is most common in people over 30. You can't stop the aging process however you can slow it down by improving your foot and leg muscles.

Gender

Statistics show that women suffer from plantar fasciitis twice as often as men. Women generally have less muscle mass and their footwear is often inappropriate. The increased weight gain with pregnancy may also contribute. These are more reasons why it is important to improve/maintain foot and leg muscles.

Weight

Extra body weight translates into extra stress on your foot and leg muscles, tendons, ligaments and bones. Stronger foot and leg muscles will handle extra body weight more effectively.

Bio-mechanical imbalances

Any biomechanical misalignment from your toes to your lower back could cause strain on your feet. Foot Trainer exercises are designed to help improve proper biomechanics.

Improper footwear

Shoes that are worn, that don't fit properly or are inappropriate for the activity are can promote PF/FP.

Dehydration

If your body is dehydrated, your muscles, tendons and ligaments will be too. Proper hydration requires 6-8 glasses of spring water per day. For every cup of coffee, soft drink or alcoholic beverage, add 2 additional glasses of spring water.

Whom To See

Family doctor

The first health care provider you should see is your family Doctor for a complete medical examination because plantar fasciitis may be a symptom or a warning of health disorders in other parts of your body. If your diagnosis is plantar fasciitis you may be referred you to a Podiatrist, Physiotherapist or Chiropractor depending on your individual circumstances.

Common plantar fasciitis tests are:
diabetes, degenerative joint diseases, lupus, fibromyalgia, ms, arthritis, lymes disease, parasites, vitamin B12 and C deficiency, thyroid levels, mercury toxicity, candida, adrenal deficiency, structural stress fractures and bone spurs.

Podiatrist

A Podiatrist should confirm your Doctor's diagnosis, evaluate your foot and leg biomechanics, advise you of treatment options and help you develop a rehabilitation plan and refer you to physical therapy or a chiropractor if needed.

Physiotherapist

A physiotherapist should confirm your diagnosis, evaluate and treat your symptoms, develop a rehabilitation plan and teach you correct exercises.
Please refer to Foot Trainer exercises and incorrect exercises.

Chiropractor

A Chiropractor should confirm your Doctor's diagnosis and evaluate/correct your foot and leg biomechanics. If you decide to try custom orthotics it makes sense to be in proper alignment before you are fitted.

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