Plantar Fasciitis Physical Therapy - Get Better, Faster | Movement Rx

Plantar Fasciitis

What is Plantar Fasciitis?

Plantar Fasciitis is a condition characterized by pain in the heel or bottom of the foot. It’s a common malady for anyone that stands, walks, or runs for extended periods of time on hard surfaces.

Treatment and Prevention

Some runners use KT tape hoping to alleviate the discomfort of plantar fasciitis but this is merely akin to putting a band-aid over the problem.
A more sound approach to treating plantar fasciitis can be done at home with some simple tools. A lacrosse ball, for instance, can be used to massage the plantar fascia as well as adjacent tissues. Applying pressure to the plantar fascia along with a “smearing” of the tissue can help break down adhesions and release tight tissue.
To be thorough, the same method can be applied to neighboring soft tissue such as the arch of the foot (downstream) as well as the Achilles tendon and calf muscles. These tissues in particular take a lot of abuse from miles and miles of running. Tired tissues become tight tissues and tight tissues are not happy tissues.
Regular maintenance as well as making slight adjustments to running technique can help greatly in improving and avoiding plantar fasciitis. If you tend to be a heel striker, try adopting a more mid-foot strike style of running. This will help distribute the load better and allow for better shock absorption with each step.
Additionally, if you are a regular wearer of flip flops, Dr. Kelly Starrett of Mobility WOD describes them as a “great way to screw up your foot machines.”
Here’s why:
When you walk from point A to B, you have to clench your big toe to keep the thing from slipping off. And when you clench the big toe, the windlass system in your foot grinds to a halt, and your plantar fascia pays the price. The tissues of the arch get gummed up and shortened, messing with all the properties the plantar fascia is designed to deliver. The kink gets distributed through multiple systems, like a shortened heel cord to entrapping the sciatic nerve, which corresponds to Achilles pathologies and neurodynamic aches and pains. All because of flip-flips.

How to “Roll Out” Your tissues To Relieve/Prevent Plantar Fasciitis

Site of the pain

Step 1: Get a lacrosse ball (preferably 3 as this give you more options later). You can get these at any sporting goods store
Step 2: Set up next to a wall or pole that you can lean on for support
Step 3: Remove your shoes and with locked out knees reach down and try to touch your toes (basic hamstring stretch). Use the distance you are able to reach down as a reference.
Step 4: With a lacrosse ball on the ground, place the front of the heel of your foot onto the ball and apply pressure. “Smear” in a circular direction (like you would to put out a cigarette) to break up adhesions. This may hurt to some degree but as long as you aren’t feeling any numbness or tingling, press on (pun intended). Understand that painful tissue is unhealthy tissue and in need of maintenance. Only apply as much pressure as you can stand and remember to breathe. Continue for at least 2 minutes or until the tissue is noticeably less painful.
Step 4: Retest the hamstring stretch. You SHOULD notice a difference between sides.
Step 5: Repeat on the other foot and then retest.
Total Time: 4-6 minutes per side

Downstream

Sometimes, when we experience pain, the REAL culprit behind the pain is “upstream” or “downstream” of the site of the pain. Dysfunctional surrounding tissue can affect neighboring tissue in an adverse way. Remember that our bodies are a kinetic chain. If one part of the body isn’t working properly, other parts will have to pick up the slack or pay the price for others not doing their job.
The same method of smearing used on the plantar fascia can be used on the arches of the feet. Test with the hamstring stretch and retest after rolling out each foot. You should notice even more of a difference there if rolling out the arches was particularly uncomfortable. Spend 2-3 minutes per foot

Upstream

Sitting on the ground, place your Achilles tendon on top of the lacrosse ball (or optionally on top of two balls taped together AKA a “peanut”).  Then cross your other foot over top of the leg that is on top of the ball. Rotate your leg back and forth (pressure wave) and/or flex and extend the ankle (tack and floss). You can move the ball up your leg up into the meaty part of the calf and continue the process. Hunt around for the spots that are especially sensitive and spent 2-3 minutes on each bit.
Optionally, you can do this same mobility exercise using the handle of a kettlebell or any hard surface. I have been known to shamelessly do this at baseball games using the top of the seat in front of me if no one is sitting there. You can be as creative as you want with this.

Remember: Recovery and Muscle Maintenance is JUST as Important to Your Training Success as is Following Your Training Program

One thing that we find very common with endurance athletes is that they spend more time on accumulating training volume and not enough time maintaining their tissues and keeping everything healthy. Just like we would not allow a weightlifter to lift heavy weight multiple times with bad form or with unhealthy tissue, this is even more important for endurance athletes who complete THOUSANDS of reps (each step is a rep) in training. The more reps you do with bad form or unhealthy tissue, the more likely you are to get injured, which will sideline your training for days, weeks or even months. 10-20 minutes per day toward muscle recovery doesn’t sound like such a big time investment now, does it?

References

Starrett K, Murphy T.J. Ready to Run: Unlocking Your Potential to Run Naturally. Las Vegas: Victory Belt Publishing, 2014. Print.

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