Plantar Faciitis: What it is, and how to get rid of it

Matt_SilvaggioYour Physical Therapy Questions – Answered.

Question: Can you explain what plantar fasciitis is and how I can get rid of it? – L. Campbell

Answer: Plantar fasciits is typically an overuse injury, an inflammation (-itis) of the connective tissue (fascia) on the bottom (plantar) surface of the foot.

This connective tissue spans from your heel bone (calcaneus) to the metatarsals of the mid-foot, contributing to the arch of the foot. It plays an important role during activities like walking, squatting, and jumping with its supportive properties to the arch. It is virtually a continuation of your calf muscles (gastrocnemius and soleus) thereby shortening when your foot is pointed away from you (plantarflexion) and lengthening when your foot is pulled up toward you (dorsiflexion). This is important to understand because it is the basic premise of how to treat your inflamed plantar fascia.

A common component of this injury is diminished flexibility of the calf, which thereby increases stress and strain on plantar fascia with every step you take. While you are sleeping at night, the fascia will begin its healing process and the swelling may settle in the area of the heel bone. And since your feet are usually at rest in a pointed position (plantarflexed) when sleeping, you typically wake up with further tightness in your calf. Then, every morning when you go to get out of bed your first steps in bare feet re-injures the fascia and a cycle of healing and re-injury begins to occur. Unless you address this right away, this condition can become subacute and then chronic, leading to a tougher road to recovery in the future.

Have a towel or yoga strap at your bedside and each morning before you go to get out of bed for the first time, sit up and stretch your calf by pulling your foot toward you with a straight knee. Once you have completed this a few times, try getting out of bed. Then throughout the day, while wearing your shoes, perform a calf stretch in standing at the wall. With your hands on the wall and your injured foot in back pointed straight ahead, heel on ground at all times, and your knee straight, lean forward until a stretch is felt in your calf. Continue to work on calf stretching 3-4 times per day without aggravating your symptoms until you feel relief. If you continue to suffer from pain in the heel and arch of your foot, consider physical therapy services where functional mobilizations are used to improve the soft tissue mobility that is not improving with stretching and the joint mobility that has been lost either from a previous injury to the foot or ankle, limping, or some other type of compensation that you may not be aware of.

A Physical Therapist can provide you with advice on the health of your foot’s arch and whether that is contributing to your plantar fasciitis. In addition, your therapist will discuss with you other causes that may be contributing to your condition and provide recommendations such as orthotics, to help you overcome this injury as efficiently as possible.

Matt Silvaggio, MSPT has been practicing across a broad scope of physical therapy settings since graduating from Nazareth College of Rochester, NY in 2003.  His experience has been shaped by working in acute rehabilitation, home health, orthopedic private practice as well as sports medicine settings.
Elite Health Services, located in Old Greenwich, (and now Westport!) CT is a world-class provider of certified functional manual physical therapy, personal fitness, golf & triathlon performance training, massage therapy and wellness related services. Our team of highly skilled and dedicated professionals take a no-excuses approach to providing exceptional care and delivering exceptional results. To learn more visit www.EliteHealthServices.

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