Why Plantar Fasciitis is More Common Than You Think

I. Introduction to Plantar Fasciitis

1. Prevalence and Definition

2. In their review on the minimally invasive treatment of plantar fasciitis, Hasewaga et al (2020) contend that one in ten individuals will develop this condition. Plantar fasciitis refers to the inflammation and micro - tearing of the plantar fascia. The plantar fascia is a robust band of tissue that extends along the arch of the foot, stretching from the toes to the heel.

3. Causes in Different Populations

4. Trainees: The plantar fascia can become a source of pain in trainees who exhibit over - pronation or wear flexible, minimalist shoes when their foot muscles lack the appropriate strength. The resulting symptoms include pain and tenderness along the arch and heel.

5. Athletes: Distinct from plantar fasciitis, athletes can also experience plantar fascia strain. This typically occurs in the initial stages of training and is associated with activities such as running, jumping, and other repetitive stress - inducing motions. Athletes who are overweight, have tight calf muscles, and weak foot - supporting muscles are at a heightened risk. If left untreated, this strain can progress into a severe case of plantar fasciitis, which may take over eight months to resolve. Additionally, factors such as age (40 - 60 years old), high body mass index (BMI), and poor body mechanics (e.g., poor ankle flexion) are associated with a higher prevalence of plantar fasciitis (Riddle & Schappert, 2004).

II. The Significance of Foot Training

1. Muscle and Joint Focus

2. It is crucial to consider training the intrinsic musculature of the foot and lower extremity, while also enhancing the range of motion of the metatarsal phalangeal joint (MPJ). The MPJ, the largest joint of the foot with the greatest range of motion in the sagittal plane, serves as the body's connection to the ground. Despite being smaller than the ankle, knee, or hip, it endures significant forces during running and jumping (Goldmann et al, 2013).

3. Weightlifting coach Robert Takano's statement, "Athleticism starts from the bottom of your feet, the way you move them eventually determine how good of an athlete you can be," underscores the importance of foot function, especially in relation to the plantar fascia. Exercises that generate a powerful triple extension of the ankle, knees, and hips, such as weight - lifting movements like the snatch, clean, and jerk, can effectively train the foot's intrinsic muscles. This is achieved when the heel is maximally raised while pushing off the ground, also beneficially stretching the fascia.

4. The Kinetic Chain and Its Implications

5. However, issues arise when there are weaknesses in the kinetic chain. In such cases, the workload on the feet is amplified to compensate. When combined with a greater body weight, this leads to increased stress, which can cause trauma to the fascia and subsequent pain. Thus, the plantar fascia cannot be considered in isolation; it is an integral part of the overall movement system. The heavier an individual is, the greater the burden on the body, with the feet being the first to bear the brunt. Athletes are not exempt from plantar fasciitis; for example, as reported by ESPN, Hall of Fame quarterbacks Peyton Manning and Eli Manning both suffered from plantar fascia tears during their careers.

III. Treatment of Plantar Fasciitis

1. Non - Invasive Recovery Suggestions

2. Rest: Relieve the pressure on the feet by avoiding standing, running, or jumping. In some instances, swimming or cycling can be substituted, as these activities have been shown to reduce pressure on the fascia (Hasegawa et al, 2020).

3. Stretch: Extend the stretching routine beyond the feet to include the ankles and calves. Specific stretching of the affected area can alleviate the pain associated with plantar fasciitis.

4. Proper Wrapping: For severe cases, consulting a podiatrist may result in having the foot taped. Taping requires proper foot positioning and can provide substantial relief.

5. Icing: Apply ice for 10 - 20 minutes, 2 - 4 times a day. While effective in the early stages of recovery, its benefits may decrease over time.

6. Foot Supports: Arch supports or shoes with enhanced arch support can offer relief. Custom inserts may not be necessary, but support is essential as a healthy plantar fascia would naturally provide arch support.

7. Night Splints: Wear a specialized boot at night to maintain foot flexion and prevent overnight tightening. Night splints may be used for up to 3 months and have proven to be effective.

8. Strength Training: Consider loaded carries upon recovery or as a preventive measure. They provide a combination of static and dynamic support for the feet.

9. Advanced Treatment Options

10. The aforementioned recovery suggestions are non - invasive. In severe cases, more invasive options such as corticosteroid injections, stem cell therapy, or surgery may be considered. However, for most sufferers, the basic non - invasive methods will suffice.

IV. Conclusion

We often overlook the complexity of basic movements like running and jumping, especially as we age. In the gym, we tend to neglect our feet, not recognizing them as a source of power. In reality, the feet are the body's connection to the ground, bearing the brunt of significant forces during activities like pushing off or squatting. As Bob Takano emphasized, athleticism begins at the feet.

References

1. Hasegawa, M., Urits, I., Orhurhu, V., Orhurhu, M. S., Brinkman, J., Giacomazzi, S., Foster, L., Manchikanti, L., Kaye, A. D., Kaye, R. J., & Viswanath, O. (2020). Current concepts of minimally invasive treatment options for plantar fasciitis: A comprehensive review. Current Pain and Headache Reports, 24(9), 55.

2. Riddle, D. L., & Schappert, S. M. (2004). Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: A national study of medical doctors. Foot & Ankle International, 25(5), 303–310.

3. Goldmann, J.-P., Sanno, M., Willwacher, S., Heinrich, K., & Brüggemann, G.-P. (2013). The potential of toe flexor muscles to enhance performance. Journal of Sports Sciences, 31(4), 424–433.