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Resolving Plantar Fasciitis

What is Plantar Fasciitis?

The suffix “itis” means inflammation. In medical literature, Plantar Fasciitis is most often described as “an inflammation of the plantar aponeurosis or plantar fascia”.

What Causes Plantar Fasciitis?

Plantar Fasciitis (PF) – like all repetitive strain injuries – typically develops over a long period of time and are caused by:

Repetitive motions that stress soft tissues in the feet and legs.
Standing on hard surfaces for long periods of time.
Existing muscle imbalances.
Increased physical activity.
Shoes that provide inadequate support.
Acute trauma to the feet.

Without the opportunity to heal properly, the fascia and soft-tissues of the feet become inflamed and irritated by continual usage. These increased stresses may result in:

Pain along the bottom of the foot.
Alterations in normal foot biomechanics with physical activity.
Development of soft-tissue restrictions through structures ranging from the bottom-of-the-foot, up through the hamstrings, and into the hips.

Resolving Plantar Fasciitis

Effective resolution of Plantar Fasciitis requires a thorough understanding of the foot, how it functions, and its kinetic chain relationships to the other structures of the legs, knees, hips, and even to the core. Any successful treatment protocol must take all these elements into account, and combine treatment with an exercise routine that addresses all affected elements of the kinetic chain. Click on each of the following tabs to better understand our treatment process.

About the Plantar Fascia

The plantar fascia is a thin band of fibrous connective tissue that runs from the calcaneus (heel bone) to the base of the toes, and acts to support the arch of the foot. It acts a tie-rod, one that tightens as the foot bears weight. Some studies estimate that it carries 14% of the total load of the foot.

Interestingly, the actual plantar fascia is rarely tender to palpation and touch. Instead, it is the deeper soft-tissue structures that show signs of injury, and which cause the pain felt by patients.

Effects of the Inflammation Process

The inflammation process causes the body to lay down additional restrictive scar tissue across injured or already inflamed soft-tissue structures, and with Plantar Fasciitis, results in a shortening of the plantar flexors.

These restrictive fibres also bind the layers of adjacent soft tissues together, and prevent these tissue layers from translating or moving freely across each other. The entrapment of these tissue layers causes further friction and inflammation.

Ultrasound measurements of tissues of symptomatic and non-symptomatic patients shows the symptomatic tissue to have increased thickening as the various soft-tissue layers adhered together. This includes structures in both the feet, and further up the kinetic chain, such as:

Calf muscle restrictions in the gastrocnemius and soleus.
Hamstring restrictions in the biceps femoris, semitendinosus, and semimembranosus muscles.
Quadratus plantae, flexor digitorum brevis, flexor digiti minimi  brevis, abductor hallucis, and flexor hallucis brevis.

Treating the Kinetic Chain

From research, and through our own clinical experience, we have learned that Plantar Fasciitis is caused by more than just inflammation of the plantar aponeurosis in one area of the foot.

We have discovered that, in addition to treating the plantar aponeurosis, we must also address:

The altered biomechanics caused by soft-tissue restrictions that have developed in other parts of the feet, legs, and hips.
The layers of tissue deep within the foot that have lost their ability to translate or move freely across one another due to restrictive adhesions that have formed between the adjacent structures.
The stresses on the body caused by altered motio- patterns as the body compensates for these injuries.

Further up the kinetic chain, structures such as the internal and external rotators of the hip can also cause problems with the biomechanics of the lower extremities.

All of these need to be addressed in order for full recovery from Plantar Fasciitis.

Treating Plantar Fasciitis with ART

To ensure complete resolution of Plantar Fasciitis, practitioners should always look beyond the immediate symptomatic area of the foot, and consider structures throughout the body that may also have been affected.

By treating these additional soft-tissue structures, the practitioner is then able to address the original biomechanical dysfunctions that may have caused Plantar Fasciitis, and thereby prevent a reoccurrence of the problem.

ART is used to find the specific tissues that are restricted and to physically work them back to their normal texture, tension, and length, using various hand positioning and soft-tissue manipulation methods.

The actual sequence of treatments, and the sites that are addressed, vary depending on the individual, and the actual cause of the problem. Most importantly, all restrictions, along the entire kinetic chain, must be released to resolve the problem.

A Patient’s Story

Dear Dr. Abelson:

I wanted to let you know about my experience with Active Release Techniques (ART). For many years I had suffered from Plantar Fasciitis on both of my feet. The pain would sometimes become unbearable. Although I wear orthotics, I could never quite get the relief I was looking for.

That is, until I heard about ART. After only three treatments with you, I received significant relief from the pain. By the end of my treatments, I was completely pain free, and have remained pain free for over a year and a half. I am very happy at the outcome and would not hesitate to use this treatment again.

Sincerely,

Patricia Van Witsen

More Information about Plantar Fasciitis

Kinetic Health provides a broad range of information resources (books, blogs, and videos) that you can use to help yourself heal from Plantar Fasciitis. Click on each of the following tabs to access these resources.

Exercises for Plantar Fasciitis

The exercises that your practitioner selects to support your soft-tissue therapy should be based upon the identification of the affected structures in your body’s kinetic chain.

You will find that some of these exercise programs will only involve the use of the lower extremities, while other programs will require the integration of hip and core exercises in order to completely resolve the problem.

Release Your Pain: 2nd Edition

Dr.Abelson’s international best-seller – Release Your Pain – provides a detailed description about the anatomy, causes, and kinetic chain of Plantar Fasciitis. It discusses means for resolving this condition, and provides specially selected exercises to help you begin the process of resolving this condition. Visit our website at www.releaseyourbody.com to purchase your eBook or hard-copy.

Resolving Plantar Fasciitis – Soon to be Released

For more information about how you can analyze your body to determine just which structures are affected, and to find custom exercises that work your affected kinetic chain, we recommend that you read the soon to be released book “Resolving Plantar Fasciitis”.

Videos for Plantar Fasciitis

Use the following videos to test your own body, and discover which aspects of your kinetic chain may be causing your Plantar Fasciitis. Click the left and right arrows to scroll through the videos.

Plantar Fasciitis: Plantar Fasciitis

How to effectively treat Plantar Fasciitis with Active Release Techniques.

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PF Test – Shin Strength: PF Test – Shin Strength

Plantar Fasciitis – On the functional shin tests for imbalances or weakness in your shins. A key area in your bodies kinetic chain where a weakness could lead to Plantar Fasciitis.

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Deep Squat Analysis – Functional test: Deep Squat Analysis – Functional test

Dr. Brian Abelson explains the deep squat analysis and what it shows you from the anterior, lateral and posterior positions.

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PF Test – One Leg squat: PF Test – One Leg squat

Using the one leg split squat to evaluate glute function. Your glutes are not only one of your major shock absorbers but they also stabilize your lower extremity.

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PF Test – Checking Posterior Chain: PF Test – Checking Posterior Chain

Functional testing of the cores posterior chain. An important area to asses for both spinal and lower extremity conditions.

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PF Test – Hip Flexors: PF Test – Hip Flexors

Tight Hip Flexors cause instabiity in the lower extremity by inhibiting hip extensor activation. This lead to conditions such as Plantar Fasciitis, and a host of sport performance problems.

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PF Test – Calf Strength: PF Test – Calf Strength

Functional calf muscle testing for imbalances or weakness in your calf muscles. Weak or imbalanced calf muscles can be a contributing factor in numerous lower extremity conditions such as Plantar Fasciitis.

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PF Tests – Dorsi and Plantar Flexion: PF Tests – Dorsi and Plantar Flexion

Functional shin testing for imbalances in active range of motion

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Blogs About Plantar Fasciitis

Plantar Fascia – Getting a Better Understanding Of Fascia

The plantar fascia is a thin sheet of fibrous connective tissue that runs from the base of your heel bone (calcaneus) and fans out to the base of your toes (proximal phalanges). The fiber orientation of the plantar fascia is very specific and very important. The plantar fascia is designed to support normal foot motions through the actions of pronation and supination.

Plantar Fasciitis – Clearing a Few Myths

Myth #1 – Heel Spurs Cause Plantar Fasciitis? Standard medical literature often uses the term ‘heel spurs’ synonymously with Plantar Fasciitis. This usage is both confusing and misleading since heel spurs are actually spike-like projections of new bone that do not usually cause pain.

Resolving Plantar Fasciitis

Of all the conditions that we treat Plantar Fasciitis (PF), is one of the most common. In fact, between the running community and the general public I see new cases of Plantar Fasciitis almost every day. This can be a very frustrating condition for a lot of people who previously have achieved only minimal or no results.

For information about our clinic in Calgary, Alberta, please visit to www.kinetichealth.ca.