Do You Have Plantar Fasciitis Symptoms?
- You get out bed and feel searing pain with that first step.
- You dread the first 10 minutes in the morning of standing and almost pee your pajama pants trying to get to the bathroom because your foot hurts so bad and you have to hobble there.
- You’ve stretched your foot, arch, and calves endlessly with no lasting improvement.
- You rolled a golf ball under your arch to the point of tears.
- You bought 16 pairs of ugly shoes only to wear your tennis shoes to work every day.
If you’re familiar with any of these situations, it’s likely that your plantar fascia is in trouble, and with the arrival of summer your symptoms only get worse. For many, summer means flip flops, cute sandals, and walking barefoot on the beach.
For others it means ramping up training to prepare for a race this fall. All of these can put strain on the bottom of your feet resulting in your poor plantar fascia becoming inflamed and irritated.
Here’s a secret…the problem isn’t your plantar fascia. It’s actually your core, your hips, and your butt.
The foot is structured in the shape of an arch with the plantar fascia, a long, flat, wide ligamentous structure like a hammock, across the bottom supporting the arch. If you have weakness of your core, hips and butt or these muscle groups aren’t working properly, they can’t maintain the correct joint position in the leg, thus placing all of the stress through the bottom of the foot.
Look at your foot when you’re standing – do you have an arch or are your feet flat like a duck? Are your ankle bones pointing inward?
When your weight is evenly distributed through the foot, the body can utilize all the muscles, joints and ligaments to support that weight. The hips and legs can then exert forces upward to hold your body upright.
When weight is unevenly distributed, the feet will rest in pronation (weight on the inside edge) or supination (weight on the outside edge). Pronation is the most common fault and can occur for a variety of reasons; one is genetic predisposition to flat feet. Another cause is weakness in the external rotators of the hip, which leads to abnormal rotation of the femur (thigh bone) and creates valgus (knees together) posture. If you follow this down the chain from the hips to the foot, the knees come together the ankles squint in too, resulting in strain on the plantar fascia.
By strengthening the core, hips and thighs and being aware of proper posture, the strain can be reduced and the plantar fascia can begin to heal.
Physical Therapist Approved Activities for Healing
Finding neutral foot
Sit on a chair with feet flat on the floor, knees bent at a 90⁰ angle with toes forward, and ankles directly under your knees. Try to create an arch by lifting the ankle bones but also keeping the big toe on the floor. The goal is to make the pointy bones inside the ankle to be level with each other (not the inner one lower than the outer one).
Make it tougher
Once you can hold that position, try it while standing. Put your hands on a table or a countertop to decrease the amount of weight on the feet and help balance. Once you can hold that for 30 seconds and repeat it 5-10 times, try on one foot. Do this in front of a mirror so you can be sure your hips stay level when you lift the foot off the ground.
Now practice it – all the time
Pay attention to your arch while you’re standing. For example, while waiting in line at the grocery store, or while brushing your teeth. The more you practice holding that arch, the easier it becomes.
Strengthen with a purpose
Squatting is a great way to strengthen the lower body, if special attention is paid to maintaining proper alignment. Imagine screwing your feet into the ground, using an outward rotation motion but not actually moving the feet. This motion lifts your arches and direct the knees ever-so-slightly outward. As you can see in the image, this helps maintain safe alignment of the knees and feet and prevents excessive strain on the joints and ligaments of the leg.
Orthotics, or shoe inserts, are often used to help maintain the arch temporarily. Ultimately though, correcting the mechanics of the leg and building strength will reduce the inflammation at the plantar fascia. So will maintaining a neutral foot position during daily activities thus preventing irritation in the first place.
Try the activities above for a few days to gain awareness of your foot position and note any changes in your symptoms. As with any exercise program, if you feel increased pain stop! The activities are designed to decrease irritation so if there is pain, it’s a signal that your body doesn’t like what you are doing to it.
If you aren’t finding relief or just can’t get the hang of it, call a physical therapist (check out our blog post How to Find the Right Physical Therapist). A thorough PT will examine the lower back, core, hips, knees, ankles and feet, not just focus on the symptoms at the bottom of the foot. The therapist will work with you to develop specific physical therapy goals and a program to reach them.
Remember the process of healing and retraining takes time and it won’t happen overnight. With work and dedication, you should be able to return to what you love doing without pain.
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