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Preventing Plantar Fasciitis

Many returning and novice exercisers are resolving to get in shape by beginning a walking program. While the benefits of such a regimen are numerous, it is prudent to be aware of some of the downsides that come with walking. It's not uncommon where walkers become overzealous in reaching their goals, whether that is reaching a target weight or walking a certain amount of miles or length of time prior to when they ought to. Injuries of the repetitive overuse type come in abundance with these faulty training habits. If one would like to stay clear of plantar fasciitis this spring, it is critical not to ramp up the walking regimen too quickly. In this article I will explain what plantar fasciitis is, and other ways to prevent this condition from occurring.

What is Plantar Fasciitis?

The plantar fascia is a thick band of fibrous tissue that functions to support the bottom (plantar) aspect of the foot. The suffix "itis" refers to inflammation. Thus plantar fasciitis is an inflammatory condition that occurs to the plantar fasica. Mechanically, the foot serves two primary roles: The first role of the foot functions as a supple structure to absorb shock, while the second purpose serves to propel the body forward acting like a rigid lever. When the role of shock absorption is overloaded either by carrying too much weight or quickly increasing a walking program, the fascia is not allowed to adequately adapt and, as a result, microtears begin to occur.

What are the symptoms of Plantar Fasciitis?

The symptoms of plantar fasciitis have a similar presentation in most people. Because the attachment of the fascia is the inner aspect of the calcaneus (hell bone), the symptoms are almost invariably located at the heel, where the inflammatory process occurs. This is why classically sharp point specific pain is felt with the first few steps in the morning, and wanes with subsequent steps. A very huge misconception exists with heel spurs and plantar fasciitis. Numerous studies have shown that heel spurs are not mutually inclusive of plantar fasciitis. This means that if one has plantar fasciitis, it does not mean that a person will automatically have a heel spur, and vice versa. Even more worthy of elucidation, heel spurs are not the source of pain. The heel spur is merely a radiographic finding indicating the length of time plantar fasciitis has existed. One does not have to treat a heel spur, but plantar fasciitis, in deed, needs clinical treatment.

How can you prevent Plantar Fasciitis?

So how could this very nagging and often debilitating condition be prevented? Well, the less stress on the fascia, the less likely symptoms will develop. The first stop is to identify potential offending activities and variables. Often this translates to losing weight, and reducing standing and walking as much as possible, sparing these activities for only daily living as opposed to exercise. This will remove the stress off of the plantar fascia. Swimming and cycling are great alternatives to maintain healthy cardiovascular integrity.

Another way in which one is predisposed to this condition is by having a tight calf-achilles tendon complex. While the mechanics of this structure can become complicated, simply stated, tightness in this region can be a big culprit for plantar fasciitis. A tight calf-achilles tendon complex will limit the upward motion at the ankle. When the ankle is restricted from moving, the foot, particularly the mid-foot, compensates by dorsiflexing (moving upward) even more, thereby causing increased stress to the plantar fascia.

Lastly, an overly pronated (flat foot) or supinated (high arched foot) can predispose someone to this condition. Unfortunately, there is not much one could do with their genetic endowment except for finding shoes/sneakers to accommodate for faulty biomechanics. Sometimes shoe inserts should be considered, whether they are off-the-shelf or customized. Try off-the-shelf orthoses for the first 2 weeks, and if symptoms do not improve, move toward having customized orthoses made for you. The latter is often more expensive in the realm of $400-$500, where the former can cost up to $30.

The most advisable way is to allow experts to analyze your feet, the way in which your foot behaves during the gait cycle, and determine if there is adequate range of motion at your ankle.

Summary:

  1. Train by gradually increasing distance - rule of thumb is increasing 10% per week.
  2. If overweight, lose weight in another way (bicycling, swimming, dieting) before taking on impact activities like walking.
  3. Stretch your calf muscle to avoid over compensation at your mid-foot.
  4. Allow an expert to analyze your feet to recommend proper shoes.

Call us today to see how we can help you prevent Plantar Fasciitis. We look forward to showing you what physical therapy can do for you.