What is the Plantar Fascia?
The plantar fascia is a very strong thick band that starts at the bottom of the calcaneus (heel bone) and passes under the arch and expands to attach to all the toes. If you pull your toes upward the plantar fascia becomes very prominent in the arch area and is easily felt. The plantar fascia is not easily damaged and it takes an incredible amount of repetitive force before it will let you know that it is angry. Although you may pinpoint the start of your symptoms, starting several weeks or months ago, it actually takes years before there is enough damage to set off the inflammation alarm. Walking will produce 2 to 4 times your body weight coming down on your foot for every step you take. There are 1,000–1,100 steps per mile. I will let you do the math and see how body mass and the number of steps you do each day are part of the equation that create plantar fasciitis.
A very poor nickname for plantar fasciitis is “Heel Spurs.” The weakest link in the plantar fascia is the attachment to the calcaneus. As damage increases in this area, the bone will try to heal over the micro tears in and around the plantar fascia producing the well-known “heel spur”. The buildup of bone take years, if not decades, to form. The spur has no relation to the plantar fascia pain and is secondary to the soft tissue damage -like smoke is secondary to a fire (not the real problem). So if the typical plantar fascia pain has been present for six months to one year and the spur has been present for five years – the spur does not cause the pain. It is very common to have plantar fascia pain in one foot and find “heel spurs” on both feet. It is also very common to have plantar fascia symptoms without any bone development. (Disclaimer – This is not true for the spur formation that develops in the back of the heel where the Achilles attaches. You can learn more about Insertional Achilles tendinitis and “Pump Bump” by clicking on these links.)
Plantar Fasciitis can be treated in multiple ways and has a significant success rate with nonsurgical, conservative treatments. Treatment options may involve a simple stretching program and shoe selection or more aggressive splinting, orthotics, and medications. If your symptoms are minor an over-the-counter (non custom) insert may be helpful. Beware of soft flimsy inserts made out of foam– they offer very little change. Double Beware of the over-the-counter inserts that you see advertised on TV from the “Not so Good Foot Store.”
I will admit that these inserts are a great way to lose weight—because your wallet will be much lighter when you leave the store. These are over-the-counter inserts for custom orthotic prices.
A stretching brace can be very helpful but is not as good as a stretching program you can do. The stretching brace must extend above the knee to have any influence. If your knee bends while wearing a stretching splint there is little to no effect. Both the Achilles tendon and the plantar fascia are very strong “ropes” and the larger guy always wins in a tug of war. By stretching or relaxing the Achiles tendon and its muscle there is less pulling on the Plantar fascia.