Plantar Fasciitis Causes, Symptoms, and Solutions

X-ray of the heelbone with plantar fasciitis. (Photo credit: Wikipedia)

There are many common ailments of the feet, ranging from bunions to fallen arches. One of the most common, and painful, that I run into on a regular basis in my Santa Rosa bodywork practice is plantar fasciitis. Technically, plantar fasciitis is inflammation of the plantar fascia, a thick sheet of connective tissue on the bottom of the foot. However, this diagnosis is frequently assigned to any number of conditions causing pain on the bottom of the foot. Plantar fasciitis is generally experienced as pain, sometimes severe, on the bottoms of the feet. This pain is often concentrated near the front of the heel and is often worst when getting up in the morning and at night.

Traditional View of Plantar Fasciitis

The “traditional” view of plantar fasciitis is that it’s caused by tightness of the calves and the heel cord. The idea is that the connective tissue fibers of the plantar fascia are contiguous with the connective tissue of the Achilles’ tendon, and from there to the calves. Unfortunately, this view is far too simplistic. In reality, there any many potential causes of the condition. In addition to the aforementioned calf tightness, some of these causes include pes planus (flat feet), heel spurs, various conditions of the big toe such as bunions and hallux limitus, genu recurvatum (hyperextended knees), inter- and intra-muscular adhesions/scar tissue, nerve entrapments, faulty gait patterns and any number of muscle imbalances. This isn’t even a comprehensive list. In spite of all this, the treatment generally prescribed for this condition is stretching of the calves and perhaps some orthotics. Successful treatment of plantar fasciitis must involve a comprehensive biomechanical analysis to determine which factors are contributing to the condition.

Common Plantar Fasciitis Symptoms and Treatments

While there are many factors that can be involved and must be properly assessed, there are some that I find more commonly than others. Muscle and fascial tightness is one of the most common, but not just of the calves. The fascia (connective tissue) of your body is, among many other things, the glue that holds your body together and supports you in movement. It’s more than just tendons and ligaments. There are sheets of fascia covering, running through, over, under, and around every muscle of the body. There are some sheets that connect various muscles together in series. These are sometimes known as myofascial lines or myofascial meridians. These lines allow pull from one muscle to transmit through to other muscles in the line, and sometimes even interconnect to other lines, creating a complex web of tension that supports the body. One of these such lines is intimately involved in plantar fasciitis. It is commonly known as the superficial back line. This line starts at the tips of your toes, runs under your feet, under your heels, up your calves and hamstrings, up the pelvis and spine, over your neck and head and eventually stops at your eyebrows. That’s right, your toes are literally connected to your face. Tension or imbalance of this line and it’s structures can all be transmitted to the bottoms of the feet, right through the plantar fascia. It is not uncommon to find tightness of the low back, for instance, contributing to plantar fasciitis. Re-balancing and possibly releasing this superficial back line can often resolve plantar fasciitis with little other treatment.

Also extremely common are adhesions and scar tissue build-up on the bottom of the foot. This is caused by excessive stresses being placed on these tissues. The body’s natural response is to reinforce over-stressed tissues with scar tissue. This corrupts the normal movement and extensibility of the tissue and responds well to a technique such as ART (Active Release Techniques) for release.

Like most other musculoskeletal and fascial problems in the body, plantar fasciitis doesn’t have a single solution that works for everyone. However, using a comprehensive system of skeletal alignment (preferably using a soft-tissue and/or neuromuscular modality), soft-tissue adhesion release, movement assessment and re-education, corrective exercise and corrective orthotics (if needed), most cases can be permanently resolved in short order.

If you feel you may be suffering from this condition, don’t delay seeking plantar fasciitis treatment. Not only will you be enduring unnecessary pain, but you’ll undoubtedly be compounding the severity and scope of your problem.