Plantar fasciitis is one of the most common causes of foot and heel pain. Pain is most commonly associated with the first steps after prolonged periods of non-weight bearing (i.e. sitting, sleeping). Symptoms typically improve with walking but could be aggravated by prolonged standing, running or improperly fitting shoes. While the pain can be significant, it is typically self-limiting and resolves with conservative treatment. Plantar fasciitis is typically a slow onset versus an acute tear or rupture of the fascia, which is more commonly caused by trauma or chronic fasciitis.
The fascia is a thick, fibrous tissue with minimal contractile properties, which originates at the heel and runs under the foot to the toes. The fascia is supported by the deep toe flexors and small muscles of the foot. It has some fibers from the gastroc/soleus via the Achilles tendon and also gets some dynamic assistance from the posterior tibialis, flexor digitorum longus, and flexor hallucis longus.
Some of the exercises I recommend for my patients include:
- Gastroc/soleus (calf muscles) stretches using a towel or belt
- Flexor Hallucis (big toe) stretches with a belt, standing
- Frozen water bottle massage ( I personally do not recommend using a golf or tennis ball due to the small surface area of the pressure as it can irritate the tendons and is more difficult to get a consistent stretch)
- Towel scrunches to increase the strength of the foot/toe flexors and intrinsic muscles
Of course, if the symptoms do not improve with basic treatment seek a foot/ankle orthopedic specialist or orthopedic physical therapist for more advanced treatment techniques which may include heel cups, night splints, instrumented soft tissue massage, modalities (i.e. LASER, Ultrasound), or dry needling.
Ken Breath, PT, ATC, LAT serves as Manager of Motorsports Outreach for OrthoCarolina and assists in evaluating motorsports needs and coordinating coverage for all teams. He has provided extensive therapy to the motorsports community for many years.