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If you suffer from heel pain, you may have been told by your health care provider (of you may have done your own investigative work via Google) that you have plantar fasciitis.
Those with plantar fasciitis know how debilitating it can be. That sharp, stabbing pain with each step is beyond annoying – it makes it very difficult to lead a normal active life.
In this entry I hope to explain what this condition is, who gets it, and what causes it. In part 2 of this entry, I will explain your treatment options.
The plantar fascia is a thick, broad, rather inelastic band of tissue that runs from your heel bone (called the calcaneus) to your toes. Its purpose is to stabilize the bones of the foot during impact with the ground, and act as a shock absorber for the foot and the entire leg.
I mentioned that this band is “rather inelastic” – what I meant by this is that it doesn’t stretch that much (studies suggest only a few percent) before microtearing (the injury process) begins. Consider this – during running, a force equal to 3 times our body weight passes through the foot with each step. This force brings the tautness of the plantar fascia close to a “danger zone” (where injury occurs) of stress with each step. Repetitive stress of the plantar fascia, and repetitive microtearing can lead to inflammation and injury.
“-itis” means inflammation. Thus, you can probably guess that “plantar fasciitis” is defined as “inflammation of the plantar fascia”.
You should note that plantar fasciitis is by no means the ONLY cause of foot and heel pain – but it is the most common type. Let your health care provider rule out other potential causes of your pain and make the official diagnosis. (Effective treatment, including effective self-treatment depends on a correct diagnosis – otherwise you can make things much worse).
So what causes plantar fasciitis? Well, as mentioned, repetitive stress of the plantar fascia is usually the culprit. But there’s more to it. Some people are more susceptible to injury than others. If you have flat feet, for example, you have greater tension on your plantar fascia even before your feet impact the ground. This means that your plantar fascia is closer to that “danger zone” of tension and stress with each step that you take, and hence, more likely to become injured. But those with high arches are also susceptible to injury. If you are overweight, you are also susceptible to plantar fasciitis, obviously due to an increased force to be absorbed by the plantar fascia. Tight muscles in the leg can also contribute to this injury, because movement (as in walking, running, etc) of the leg depends on the co-ordination and activation of many different muscle groups at the proper time. A disruption in the proper movement pattern can place a greater burden on the plantar fascia – and, you guessed it, can lead to injury. Improper shoes can also be significant contributor to injury, as they can create or enhance faulty foot mechanics, promoting a greater likelihood of an injury scenario. There can be other causes of plantar fasciitis – but I think you get picture.
Finally, who is likely to get plantar fasciits? For starters, if you are over the age of 40, you have a higher likelihood. Sorry - that’s just the simple statistics. Certain occupations and certain sports place a greater stress on the plantar fascia – distance running, ballet, aerobics, and occupations that require a lot of walking or standing on hard surfaces – factory workers, teachers, waitresses – all can increase the likelihood of developing plantar fasciits. And, as noted earlier, obesity as well as faulty body mechanics (low arches, high arches, tight muscles) all contribute.
Since walking is essential to daily activity, plantar fasciitis often does not just “go away on its own”. That is to say, it is very difficult for healing to take place when we are repetitively irritating the already damaged structure. Thus, those with plantar fasciitis can suffer for months to years. That’s the bad news.
The good news is that effective treatment does exist. In my next entry, I will discuss your treatment options.
In the meantime, if you think that you, or anyone that you care about, suffer from this condition, do yourself a favour and have it properly assessed by an expert. Of course, we at Kawartha Therapeutic Centre are most happy to provide a thorough assessment and treatment.
Yours in health,
Dr. Michael Carney
B.Sc., (Hons.), D.C., D.Ac., C.S.C.S
