By far, the most common cause for heel pain in athletes, runners, and the average joe is plantar fasciitis. Conventional wisdom is that it is caused by excessive tension along the plantar fascia that runs from the heel to the base of the great toe. You may have heard that it is caused by having “collapsed arches”, which increases the fascial tension thereby creating excessive traction on the heel. This line of thinking also leads many to think that is what eventually causes heel spurs. Plantar Fasciitis typically causes a stabbing or pulling pain that may occur even first thing in the morning. Symptoms may “go away” as you move more throughout the day.

Many people that suffer from PF will seek podiatric or orthopedic specialsits and opt for cortisone injections. This may temporarily help decrease the inflammation but is actually often just masking the symptoms due to lack of addressing the underlying problem. Granted, it may be a very quick way to relieve the pain associated with PF (and may have long lasting effects) but the probability of symptoms returning remains relatively high until the causes are treated. Other treatment options may include orthotics, or night splints.

At Backfit we have great success with treating plantar fasciitis in a limited number of visits. Treatment includes FDM manual therapy, stretching, and very specific rehabilitative exercises. With the treatment and exercises we are able to restore connective tissue tension and strength allowing the injury to heal in a more efficient and effective manner. We strive on staying up to date with the most recent research. For example, recent studies show that bone spurs form at the insertion of flexor digitorum brevis, not the plantar fascia. This research showed that the plantar fascia actually functions passively to store and return energy while the muscles of the arch play a bigger role in sharing the load. It is the musculature (in conjunction with support of the fascia) supporting the arch through the gait process not the plantar fascia itself that maintains arch height. In fact, this is a good explanation why plantar fasciitis is not related to arch height at all.

Abreu M, Chung C, Mendes L, et al. Plantar Calcaneal enthesophytes: new observations regarding sites of origin based on radiographic, MR imaging, anatomic, and paleopathological analysis. Skeletal Radiol. 2003;32:13-21

Wearing S, Smeathers J, Yates B, et al. Sagittal movement of the medial longitudinal arch is unchanged in plantar fasciitis. Med Sci Sports Exerc. 2004;36:1761-1767

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