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“It feels like someone is digging an ice pick into the bottom of my foot.”
“The first few steps out of bed are so painfulI that I can barely walk in the morning.”
“I have been training for this upcoming half marathon. It is four weeks away and I can’t run anymore because my foot hurts so badly.”
Heel pain. If it’s something that you’ve never encountered before let’s pray that you never do. If it’s something that you have had in the past, let’s pray that it never comes back. If it’s something that you’re currently experiencing, my heart truly does go out to you! Plantar fasciitis is, in my opinion, one of the most difficult, debilitating injuries to have. You never realize how much you use your feet until every step hurts. As a physical therapist, this is a condition that I encounter daily. Fortunately, there is a lot that you can do about it! In today’s “Feel Better Now” series we’re going to be discussing plantar fasciitis – what is it, why it’s there, and (most importantly) what you can do about it to Feel Better Now.
What is it? The plantar fascia is a large, broad ligament on the bottom of your foot. It starts on your heel and then fans out to each one of your toes. It’s job is to add structural integrity to your foot, support your arch, and basically keep your foot from falling apart. The plantar fascia also acts as a shock absorber as we’re walking/running and can even provide a little recoil as our foot comes off the ground to maximize energy (literally giving us a “spring in our step”). It’s really quite a remarkable structure when all things are working the way that they should. But what about when that’s not the case?
Why is it there? Given all these functions the plantar fascia is usually under a fair amount of stress. Plantar fasciitis occurs when this ligament is placed under too much stress/strain (usually right at the place where the plantar fascia attaches into the heel) and initiates
an inflammatory response. (Random nuggets of knowledge – Anytime you hear the suffix “-itis” on the end of a word that means inflammation. Tendinitis = inflammation of the tendon; bronchitis = inflammation of the bronchioles/airways; dermatitis = inflammation of the skin; etc.). Now don’t get me wrong, inflammation is a good thing. Without this response our body would never recognize that it was injured and therefore never heal itself. However, inflammation can be a real pain in the foot (literally) if it develops into a chronic state (lasting >2 weeks). This is when things can really start to be a problem as no longer are we just dealing with an acute inflammatory response. All of a sudden the problem has developed into that we would call plantar fasciosis.
Anytime you hear the suffix “-osis” on the end of a word that’s indicative of degeneration. Now don’t get too worried about this- it’s not wasting away to nothing. It simply means that you’ve had the problem a little bit longer and your plantar fascia has started to develop some scar tissue in response to the chronic inflammation (the body’s natural healing mechanism is scar tissue; also a good thing at the right time and in moderation). This distinction becomes very important when we start talking about the treatment of your plantar fascia pain. One would treat a plantar fasciitis very differently than one would treat a plantar fasciosis.
So how do you tell the difference? I usually use time as my determining factor: if it’s been bothering you for less than 2 weeks we’ll call it plantar fasciitis and if it’s been going on for more than two weeks we’ll call it plantar fasciosis. With me so far? Good. So what the heck do we do about it?!
Disclaimer: The information presented in the “Feel Better Now” series is designed to be used for informational purposes only. The diagnoses and treatment plans outlined are extremely generalized and may or may not be the recommended interventions for your specific problem. If you are experiencing pain, you are encouraged to consult a healthcare provider to determine the best treatment plan that will be in your individual best interest. Tone and Tighten claims exemption from accident, injury, or perpetuation of any injury incurred while performing exercises found on this website. The user assumes all risk… and reward!!
Make it happen,
Jared
