If walking causes severe pain in the heel of your foot, chances are you have probably developed Plantar Fasciitis. This is an inflammation of the plantar fascia that runs along the bottom of the foot. How does inflammation begin in these tissues and what can we do to resolve it?
Some Common Causes of Plantar Fasciitis
The plantar fascia typically becomes inflamed due to an overuse of the tissues without the tissue having a chance to rest and recover. We usually see this occurring when the foot is collapsed (flat feet) and has lost the ability to arch up to lock the foot. If, say, you are trying to reach your 10,000 steps for the day, that means one foot is not functioning properly for 5,000 steps a day!
Another issue that can instigate plantar fasciitis could be a bone spur. Bone spurs are calcium deposits that your body creates to structurally improve areas of bone tissue that are receiving a lot of wear and tear. Once again, this could be caused due to the tissue moving abnormally over the bone and your body deposits more calcium in that region in order to protect the bone. In these instances, typically minor surgery is needed to shave the bone spur down. You will then need to focus on improving the functionality of the foot so it doesn't come back.
Functional Movement Approach to Plantar Fasciitis
With knowing that plantar fascia pain is due to inflammation within the tissue, which could be caused by the issues discussed above, we need to figure out why the tissues are being overused and not functioning properly. Some of the biggest related culprits are mentioned below:
In our chair-born society, tightness of the hips is a pretty regular occurrence. This is seen in our lack of extension through the hip flexors (front hip) and an inability to rotate the hips. To quickly break down why length in the hip flexors and rotation of the hips is important, let's look at the roles these have during walking.
When the front foot lands on the ground, the arch should collapse, creating a "loosey goosey" foot. This helps to turn the muscles in the back of your hip to be able to support and stabilize you.
As the foot moves to become the back foot, this is where the extension in the front of the hip comes into play. If the hip flexors are tight, 3 things could happen:
- The back foot could rotate outward, keeping the arch of the foot flat and stressing the tissues.
- The knee could bend instead of straightening out, which will keep the arch of the foot flat.
- The stride length could be shortened, not allowing enough time for the foot to arch up and 'stiffen' in order to propel you forward.
Also, this is where the lack of ability to rotate in the hip can play a big factor in whether your foot stiffens or stays flat. The back leg should be rotating outward, which helps to move the heel inward and locks up the foot. If this isn't happening, expect symptoms of plantar fasciitis to arise at some point.
Thoracic Spine (Mid Back)
Another area of the body that tends to tighten up from being in a chair all day is the thoracic spine. This part of the spine is very important for activating your core during any movement. With its ability to bend forwards, backwards, side to side, and rotate, it activates all of the core muscles any way that it moves. However, when we sit for extended periods of time, and don't work to improve flexibility in this area, then we start to lose the ability to move all of these different ways. This will affect how the rest of your body moves and you may run into some of the issues stated previously in this article.
Sometimes one side of the body may be more tight than the other, causing an increase in rotation of your lower body to one side and not the other. This could make one foot consistently flat and the other stiff which would cause plantar fasciitis on one side.
We will discuss ways to improve the range of motion in these two areas to improve function all of the way down at the foot.
Improving Range of Motion in the Hip Flexors
Instead of looking at the body as specific muscles, we will be looking at the muscles more as regions of the body. When we talk about Hip Flexors in this case, we will be talking about the front of the hip, the front of the thigh, and into the groin area. This will make it easier to understand where stretching is taking place.
Below will be a series of videos related to stretching the "hip flexors".
In the first video, you will start off in a half kneeling position with the back foot elevated on a box of some sort. You will actively drive your pelvis forward and back for 10 reps. Then, bring your pelvis all the way forward and maintain that position as you sway your pelvis side to side. Finally, keeping the pelvis forward, try and rotate the pelvis around, creating an internal/external rotational component to the kneeling side. For added stretch, you can lift up the same side arm as the kneeling leg.
In the second video, you will take the same idea as the first video, but bring it more into a standing position with the back foot on a chair of some sort. In this position, you want to make sure your chest is up tall and you aren't arching too much from your lower back. If you have a big arch, either use something lower than a chair, or do it on the ground. Be actively trying to press the back heel away and behind you. Use the same pelvis moves as the kneeling exercise.