Plantar Fasciitis is massively common and so often poorly understood.
- Plantar fasciitis affects 10% of the population at some point in their lives
- About 90% of those cases of plantar fasciitis resolve within 12 months with conservative treatment
It’s true, you can rehab your heel pain back to begin pain free and full function but you can just sit and wait. You can’t just rest it. If you want to FIX your Plantar Fasciitis faster, you need to support it, stretch it and most importantly STRENGTHEN it.
There are a lot of misconceptions, such as
- You just must put up with it
- You have to have a cortisone injection
- It’s because you have a heel spur
That is simply not the case.
Just line many soft tissues pains and injury, our bodies are brilliant at adapting and healing if given the right conditions and stimulus through guided rehab. If you leave it and just rest it, there is less likelihood that the tissue changes. Plantar fasciitis is effectively a condition where your tissue has adapted wrong. Instead of getting stronger and better, it hasn’t had the chance to do that an instead it has become thickened and painful. You can ease this and actually make it adapt back so that you are pain free and functional again.
This can be done through effective, evidence-based rehab and that is what is outlined in this guide. Lots of information and lots of advice and exercises that are going to help you work n fixing your Plantar Fasciitis.
This guide is research guided and if needed, I have made a reference list at the end of the guide. Now, let’s get started on exactly what your plantar fascia is, what is does and how to proactively rehab it.
What is the Plantar Fascia?
Firstly, to be able to explain what plantar fasciitis is, I need to first explain what the plantar fascia is and what it’s function is because knowing what it’s role is lays the base of understanding what it takes to help fix plantar fasciitis.
Your Plantar Fascia is a very strong band of connective tissue, largely made up of collagen. Specifically, in anatomical studies, the plantar fascia has been shown to be made up predominantly of type 1 collagen fires and has very little elastin fibers in it. This means that it is not an elastic tissue – it is a very strong, in-elastic tissue.
Think of it like a flat rope.
A very strong rope that originates from the underside of your heel bone and runs all the way along the bottom of your foot to the base of your toes.
The plantar fascia is made of three main parts, a lateral band, a medal band and the central band. The central band is the largest and most prominent
The Role of the Plantar Fascia
The Plantar Fascia’s role is two-fold.
First, simply, the plantar fascia acts as a tie-rod to support the arch of the foot when weight bearing. When body weight is placed through the foot, the rope-like plantar fascia becomes taught and stops the balls of the foot spreading away from the heel and hence helping maintain your arch integrity. This gives us a stable platform to move when weight bearing, when it is needed and when weight is off, the plantar fascia is off tension again.
Side note: Everyone’s arch height and make-up is slightly different but, in most cases, that is normal for YOU.
Secondly, the plantar fascia helps us walk, run, and jump efficiently through the Windlass Mechanism:
The windlass mechanism is an integral function of the foot that is critical to efficient walking and running. I am going to tell you all about how the windlass mechanism works to help you do what you love and how to test it yourself!
It is so incredibly important that this works. If you want to keep walking or running pain-free – you need this mechanism functioning.
How does the windlass mechanism work?
As already mentioned, when we are weight-bearing on the foot, the plantar fascia is already under some tension and helping maintain our arch integrity but the really fantastic part of the mechanism is at the end of the gait cycle when our heel comes off the ground.
As the heel comes up and the big toe stays on the ground getting pushed up into extension, the plantar fascia is put on further stretch.
This winds the fascia around the balls of your feet (the base of your toes as shown in the image) like a pulley system which shortens the distance between the heel and the balls of your feet to raise and stabilize the arch of your foot even further.
This means there is no weak point in the foot – it is nice and stable to that you can really push-off and not lose any force at the time that you need it.
Plantar fasciitis – What it is
It is pain and structural changes to the fibres of the plantar fascia right at the start of the plantar fascia, near where it inserts into the bottom of you heel bone. The plantar fascia gets overloaded and this isn’t purely just due to you walking or running too much. There is normally a combination of factors that lead to the fascia taking more load than it is hardened to combined with not enough time between being loaded to adapt adequately. This lack of time to adapt leads to the plantar fascia (think of it like a tendon) adapting wrong and reactively thickening and becoming hypersensitive and painful as a way of protecting itself. Hence the use of the more accurate term “plantar fasciopathy” these days as in the condition there isn’t evidence of a significant amount of inflammation.
Normally through everyday use, we sustained micro damage to our tissues and typically, these are mended and fixed by our body. But, when we ask more of our body than it is used to and without enough time to adapt, your body gets stuck in the turnover and healing phase – this leads to thickening of the fascia and increased sensitivity and pain due to growth of new micro blood vessels and nerves.
The great thing is that you need to know when you have plantar fasciitis is that your plantar fascia is not weaker. It is thickened and painful with disorientated fibers BUT you can, as pain allows, and within reason, keep moving – you are not doing harm.