by Lisa Perry
Have you ever gotten up out of bed and felt pain in the soles of your feet as you take your first few steps of the day? As you get your feet moving, the pain lessens, only to return in the later part of the day?
It is estimated that 1 in 10 Americans suffer from foot pain related to plantar fasciitis at one point or another in their lifetime. Plantar fasciitis is an overuse syndrome characterized by localized inflammation or degeneration of the plantar fascia at its anatomical insertion on the calcaneus (heel bone). The plantar fascia is a thick fibrous band of tissue that connects from heel to the ball of your foot. It has the ability to stretch slightly, but its primary function is to support the arch of the foot. When it is strained or overused, it becomes inflamed or even tears.
What is the cause of this common foot pain? The most obvious answer is that the plantar fascial band has become weak and is unable to support the arch of the foot. But why did it become weak in the first place? Many people will quickly point to the shoes that they wear and this is a great start…but it’s just one piece in this puzzle. Wearing higher-heeled shoes, whether it is your fashionable heels for work or running shoes that have extra padding under the heel, puts strain on the plantar fascia. Anytime your heel is higher than the ball of your foot, it changes the alignment of your entire leg, pelvis, and spine from the place in which they were intended to function most efficiently. Remember our original blueprint has us barefoot and not in shoes. When the heel lifts, the shin bone moves forward, which causes the knee to buckle. In order to keep the knee from buckling and our leg from giving out on us, our calf and hamstring work together to keep the knee straight (see Figure 3). This means that the calf and hamstring are constantly over-working while you are wearing your heeled shoes and this quickly becomes a permanent pattern.
I mentioned earlier that shoes were only one piece of the puzzle. There are many people who do make better footwear choices and yet find themselves suffering from plantar fasciitis. Many athletes who rely heavily on their hamstrings and calves for their skills, such as runners, dancers, gymnasts, etc., can easily fall victim to this pain, but there are many who don’t fit in this category either. Our posture also plays a large role in how our hamstrings and calves react to gravity to support and maintain our verticality. Most of the American population has adapted a posture in which the pelvis is tucked under and shifted forward. Placing our pelvis in this forward, tucked under position, creates the same buckling effect on the knees as lifting the heels. Therefore our hamstrings and calves have the same reaction.
You may now be asking how one avoids or heals plantar fasciitis. I have discussed the causes above, but the truth is that there is not one cause; it is a combination of all of them. In order to truly avoid or get rid of this foot pain, you must address all of the causes.
- Choose shoes that are flat and secure so that your feet don’t have to work to keep them on. Flips-flops and shoes that are too loose for your feet can also create an extra strain on the plantar fascia.
- Pay attention to your posture, specifically the placement of your pelvis. The bottom of your pelvis should be free from tension and released away from the back of your thighs, so you have a sensation of your sit bones dangling. The pelvis should be centered over your extended and vertical legs, sending the weight through the center of the ankles and into the heels of the feet.
- Stretch your calf muscles properly and sufficiently. Your calf muscles attach to your Achilles tendons, which attach to your heel bones. The calf muscles are responsible for lifting the heels when you walk, run or reach for items on a higher level. If they are chronically tight, they are always “lifting” your heels and straining your plantar fascia. (See Movement Moment)
- Stretch your hamstrings correctly. Your hamstrings attach to the sit bones at the bottom of your pelvis. If your hamstrings are continually tight, they are constantly pulling your pelvis under and forward. Lengthened hamstrings will not only help your feet feel better, but they will help your back feel better too. (see Movement Moment below)
By taking these steps daily, you can easily avoid plantar fasciitis in the first place. If you are one of the unfortunate ones who are experiencing plantar fasciitis now, it is even more important that these steps become part of your daily habits. The severity of your pain will most likely determine how long it will be before your pain goes away completely, but you should notice some relief almost immediately.
Stand with a neutral pelvis (front of pelvic/hip bones in vertical alignment with pubic bone) centered over your extended legs, sending the weight through the center of the ankles and into the heels. Outsides of the feet should be parallel to one another. This may feel and even look pigeon-toed, but it’s not. Place the ball of one foot on a ½ roller or a tightly rolled up bath towel, keeping the heel of the foot on the floor and neutral alignment in the pelvis and both legs. The legs should ideally be next to each other, but you may move the foot not being stretched back if the position is too intense or you are unable to keep your heel on the floor. Hold the position for about 60 seconds and allow the calf to soften and relax down the back of the leg. Repeat with bent knees.
Lie on your back with a neutral pelvis and legs extended in parallel. Place a yoga strap or belt around the arch of one foot. Start with the leg to be stretched low and completely straight. Raise the leg towards you while keeping it straight as well as maintaining your neutral pelvis. Try to keep the front of the thigh relaxed during the stretch. Hold position for 60 seconds. Can also repeat with thigh rotated out and then rotated in.