Dr. Mike’s Rundown: Why does Plantar Fasciitis happen?
“To him whose feet hurt, everything hurts” – Socrates
Pain on the bottom of your foot? Is the first step in the morning the most painful of the day? Sounds like Planter Fasciitis; the inflammation of the fibrous spiderweb-like fascial tissue that extends from the toes to the back of the heel. When inflammation, irritation or even tears occur, pain radiates throughout the foot sending hot, searing pain from the heel to the ball of the foot. But why does this happen, and more importantly, how do you fix it?
What are the main causes of Plantar Fasciitis?
Both flat feet and high arches are in part caused by the sedentary lifestyle that most people lead and can have a big impact when it comes to Plantar Fasciitis.
- Flat Feet (Pes Plantus): We sit for too long and don’t walk enough. When we sit for prolonged periods, our body stays bent forward or forward flexed, which moves our center of gravity in front of us. This puts tension on the calf muscles, which in turn flattens the arches. And when your arches are flattened, you put tension at the insertion site of the heel, causing Plantar Think about it in terms of your car: when you have a flat tire, it puts pressure on the rims; you never want to run on rims alone.
- High Arches (Pes Cavus): High Arches are caused by an extremely rigid foot. This foot type is not very flexible; it causes too much shock to be absorbed in your foot with every heel strike. If you were a car, high arches would mean that you would have too much tire pressure, so you would feel every bump on the road. Your shock absorbers wouldn’t be working either, meaning there would be too much tension on the plantar fascia, leading to inflammation.
Plantar Fasciitis occurs when there is a strain on the ligament that supports the arch. 60% of the population is overweight. Consider the car metaphor again, if you put too much cargo in your small-tired car, the car will not be able to carry the load and ultimately bottom-out. Repeated strain will cause tiny tears in the ligament that can lead to pain and swelling in the Fascia. In addition to overburdening the foot/arch with too much weight, a lack of strength caused by a lack of walking weakens the foot and lower extremities. This combination of insufficient walking and obesity is detrimental to the heel, which gets pressure with every step you take.
This isn’t fair, but Plantar Fasciitis most commonly occurs in people between the ages of 40 and 60. It can occur from injury or it can be related to underlying diseases that cause Arthritis. At times it can even occur for unknown reasons to people that fall in this age group.
Poor Biomechanics, or body motion
When feet roll inward during walking, also known as pronation, abnormal stress is put on the Plantar Fascia and heel, which can lead to inflammation and pain. Having an abnormal gait can also overwork or abnormally stretch the Fascia tissue, resulting in tears and inflammation.
Improper shoes that lack support
Improperly fitting or unsupportive shoes are damaging to the tendons, muscles, ligaments, bones and nerves in your feet. This especially affects women as they often wear shoes, such as high heels, that either do not fit properly, or provide inadequate support or cushioning. Walking or exercising in improperly fitting shoes, can cause weight distribution to become impaired causing stress to be added to the Plantar Fascia ligament.Wearing supportive shoes may be the easiest action you can take when it comes to your foot health.
Who gets Plantar Fasciitis?
- Athletes who put excessive or strenuous physical activity on their feet can be prone to Plantar
- Arthritis sufferers experience Plantar Fasciitis due to the constant inflammation, boney degeneration and lack of motion. This is particularly common among elderly patients.
- Diabetics experience Plantar Fasciitis due to an inability to recover and/or heal. This is largely impart due to the diabetic’s tendency to blood vessel and nerve breakdown. Regular examinations of the feet are necessary as diabetes can also cause numbness and lesions in the foot and ultimately infection.
- Obesity is also a factor that can contribute to heel pain and damage. Obesity places undue stress and strain on the Plantar Fascia, ligaments and bones of the foot.
- Pregnancy leads to hormonal changes and a sudden onset of excessive weight. In particular, pregnancy causes a hormone called relaxin, which causes ligaments and other tissue to relax. As the foot relaxes, the arch will potentially collapse, becoming more strained and ultimately lead to Plantar
What are the most common symptoms associated with Plantar Fasciitis?
The most common complaint associated with Plantar Fasciitis is a burning, stabbing or aching pain in the heel of the foot. Most sufferers will feel pain in the morning, but as the day progresses the pain usually decreases. Flare ups can occur after long periods of standing, physical activity or after getting up after long periods of sitting.
For most people, heel pain is at its worst with the first steps in the morning. When you are asleep, your foot rests in a downward, Plantar-Flexed position. Here, your calf muscles and PlantarFascia become tight. Therefore, when you take your first steps in the morning, you are stretching the PlantarFascia, which causes an extreme amount of pain.
When rising from a sitting down position, pain may also be felt in the foot. In this scenario, your PlantarFascia is in a tightened position while sitting down and when you get up from being seated, you feel the stretch of the Fascia.After prolonged standing and walking, you will also feel heel pain. That’s why many people complain of sore heels after a long day on their feet. You may be surprised to hear that most people feel more pain after standing than walking. This is because you have more tension on the Plantar Fascia while standing than during the actual movement of walking.
There are three levels of pain and discomfort when it comes to Plantar Fasciitis. These degrees are:
- Mild, which is characterized as strain and/or tears to the PlantarFasciaand discomfort upon waking.
- Moderate, which is a more intense pain upon waking an additional pain throughout the day, including heel pain.
- And lastly, Severe which is characterized as very intense pain, especially in the heel, indicative of a heel spur—a pointed bony fragment that stems from the heel bone— that has resulted from the Plantar Fasciitis, making it more painful and even difficult to walk.
As you can see Plantar Fasciitis is a complex issue and can affect many depending on your lifestyle. Luckily, there are solutions(Link again to url) to the discomfort and pain associated with Plantar Fasciitis. Some treatments include the use of Electrical Muscle Stimulation, Instrument Assisted Myofascial Release, Physical/ Physio Therapy and more.