Introduction
Photo by Alina Prokudina
Plantar fasciitis is commonly attributed to a painful irritation of the plantar fascia that makes up the bottom arch of the foot, from the ball of the foot connecting to the base of the heel. Typically, the pain will be most irritable near the base of the heel, usually starting first thing when you get up from bed and subsiding after you’ve been moving for a few minutes. This pattern of pain sometimes happens at the onset of activity as well.
Some common treatments of plantar fasciitis include:
- Rest
- Pain-killer drugs or ice
- Orthotics or physical therapy
- Plantar fasciitis taping
- Corticosteroid local injections
- Surgery
Some of these treatments, however, are not sustainable as they are simply addressing the symptoms rather than the root cause. In this article, we will look to answer some questions like “can I run with plantar fasciitis?”, “does plantar fasciitis go away?”, and “what types of physical therapy for plantar fasciitis works?” along with some information to help you understand the mechanism behind your plantar heel pain that Functional Patterns has found to be useful in treating and resolving it.
Why Won’t My Foot Heal?!
If you have been noticing symptoms of plantar fasciitis, it’s important to begin addressing it immediately instead of delaying it until it becomes debilitating. You may be seeing a specialist that deals with foot pain and they may recommend that you take pain-killers, such as Ibuprofen, or icing the problematic area in order to numb the pain.
Other suggestions may include the use of a night-splint or orthotics in your shoes, physical therapy, taping, corticosteroid injections, or even surgery if the symptoms get too extreme. If you have tried some of these recommendations and are still dealing with the symptoms of plantar fasciitis, some questions to propose to yourself and your specialist are:
- Are they addressing the symptoms of your foot pain or the root cause behind it?
- Are you in a state of regeneration in which your body can actually heal or are you constantly under stress?
These questions lead us to our first typical recommendation from specialists that most people underestimate or fail to fully understand the implications of, and that is rest.
Rest or Run?
When someone first develops sudden irritation of the arch of the foot, difficulty in bearing weight on the heel, swollen feet, or stiff calf muscles, the symptoms can be so minimal that one may believe that their foot might overcome the problem by employing convenient therapies without ceasing their running regimen. Someone trying to push through the pain should consider the potential consequences of doing so. Whether they have an important athletic competition coming up or if it is just for leisure activity or exercise, their decision could lead to serious harm which would then require more invasive treatments and make it more difficult to fix the root problem afterwards.
Functional Patterns’ advice for those who are beginning to experience symptoms of plantar fasciitis is to employ a movement elimination protocol. This means that you should halt all forms of extraneous physical activity in order to address the root cause of your distress.
One might then have questions or concerns about stopping all other forms of exercise such as:
- How will I maintain my cardiovascular fitness?
- Will I maintain my muscle mass and strength?
- What do I do for exercise instead?
To understand the nature of these questions and whether they are worthy of concern we should think of the movement elimination protocol similar to that of an elimination diet, when one is dealing with gut inflammation and they need to remove certain foods to see how their body responds.
Photo by jcomp
If you never give your body a chance to remove the stimulus or stress that is causing the dysfunction to begin with, it is unlikely you can get ahead of the issue.
This is especially important when you begin to address your biomechanical dysfunctions with the 10 Week Online Course or with the help from a certified Human Biomechanics Specialist, as continuing to perform other forms of exercise will make it difficult to teach the body new patterns of movements when you keep falling back to old patterns that got you hurt in the first place.
Therefore, Functional Patterns recommends eliminating all other forms of physical activity so that the body can learn to rest and heal the body more optimally, while simultaneously working to improve the biomechanical efficiency around standing, walking, running, and throwing.
If you would like to know more about other ways you can get better results with FP, check out this article below.
What is Rest?
When thinking about rest, we have to understand how the body deals with stress. We have two systems that work together called the sympathetic nervous system (SNS) and parasympathetic nervous system (PNS), respectively the “fight or flight” and “rest and digest” system. Both are highly dependent on each other in order for a living animal to maintain the function and health of every cell in their body when undergoing high levels of stress.
According to this study, researchers found that in response to stressors and relaxation, SNS and PNS activity are reciprocally coupled with one another. This means that when a person is doing something stressful, the activity of the SNS increases while the activity of the PNS decreases, while in moments of relaxation, it is reversed.
In Why Zebras Don’t Get Ulcers, author and professor of biology and neurology at Stanford University, Robert M. Sapolsky writes that “during stress, growth and tissue repair is curtailed, sexual drive decreases in both sexes; females are less likely to ovulate or to carry pregnancies to term, while males begin to have trouble with erections and secrete less testosterone. Along with these changes, immunity is also inhibited” (Sapolsky 11).
Photo by wirestock
What separates modern humans from the animals living in nature and their ability to deal with more stressful situations like hunting or being preyed upon?
In modern times, humans very rarely achieve extended moments of deep relaxation. Most humans scroll through their social media feeds, binge-watch TV shows, listen to music, read books, meditate, or any other activity that distracts themselves from being able to achieve those states of deep rest and relaxation. By overstimulating our senses, our bodies won’t be able to achieve an optimal level of PNS activity to allow us to fully recover from running, our physical day job, or maintaining a functioning home and family.
Photo by Freepik
When you get home today, will you flip on the television or scroll through your social media outlets and become more stressed right before bed, the time when your body should be at its most rested state? Or will you take some time and just lay down without distractions and prepare the body for sleep so that it can rest deeply, repair itself, and keep the body in tip-top shape for the next day?
If I Don’t Run, I’ll Lose My Gains!
Now that we have covered how chronic stress can affect our ability to rest and regenerate more optimally, your journey in addressing your biomechanics will be far more efficient. Since you have now been taking a break from running, what else can you do to maintain your cardiovascular fitness, muscle mass, and strength while addressing the root cause of your plantar fasciitis?
When we start getting symptoms of pain showing up on the bottom of our feet, it’s important to understand the connections between this area and the rest of the body, and the types of exercises you should avoid that might create more problems down the road.
Myofascia
We must first understand that our muscles connect to one another through fascial sheaths called myofascial chains. These chains act like rubber bands that hold our skeleton up in space; if there are any areas along this myofascial chain that get dehydrated and lose their elasticity, those areas could potentially get stuck in a non-contractile shortened state within that myofascial chain. This may lead to overcompensation of other muscles, causing them to overwork to pick up the slack.
Anatomy Trains, T.M. Myers
The superficial back line starts with the plantar fascia connecting to the calves, then hamstrings, spinal muscles, and the eyebrows. So if all of these muscles are connected and work together to keep us upright, could the plantar fascia overcompensate if your hamstrings are constantly being dehydrated from sitting all day? What about the spinal muscles of the back being overworked because you’re stuck in a kyphosis (pictured on the left below).
Results by Stephen Maguire from Functional Patterns Dublin
Potentially. But don’t think that doing yoga or passively stretching those dehydrated regions will fix your plantar fasciitis. Your body needs an active mechanical driver (a torque being applied to a joint to facilitate movement, e.g. a gear turning an adjacent gear) that respects physics and the laws of gravity to rehydrate those tissues in the contexts of standing, walking, running, and throwing.
If you employ techniques that don’t respect physics and our paleobiological means of ambulation, you will most likely exacerbate your pain rather than relieving it.
If you would like to understand our views on yoga and stretching, please check out the article below.
How FP addresses Plantar Fasciitis
So now we understand how the plantar fascia is connected all the way up to the top of our head, what physical therapy exercises for plantar fasciitis do professionals recommend?
Some common exercises are:
- Plantar fascia massage
- Heel raises
- Ankle inversions with resistance
- Seated toe towel scrunches
- Seated plantar fascia stretch
- Wall-facing calf stretch
As you might have noticed, all of these exercises seem to target the foot and lower leg alone but nothing above the knee. This is an example of incorporating isolation exercises that solely address the symptomatic area of the foot instead of addressing how the foot is compensating for a dysfunction in the rest of the body. We are not saying that the above exercises won’t help reduce your pain or symptoms, but it doesn’t seem reasonable or efficient to have to do these exercises every day, especially if it does not integrate with the rest of the body.
By implementing the Functional Patterns approach, a simple hamstring retention exercise can reintegrate the connection between your plantar fascia through the hamstrings and into your thoracic spine. This will help the muscles of your foot and calf muscles to participate with the rest of your body in movements outside of this exercise alone.
The contralateral step row and press are two great examples of exercises that respect gait and provide a relevant context to prepare your plantar fascia for running. For example, take a look at the position of the arms and legs in the photos above and below; do they not represent a similar position when we run? Perhaps, more physical therapy for plantar fasciitis should institute these exercises into their protocols.
Conclusion
So can one continue running with plantar fasciitis while simultaneously receiving plantar fasciitis massage, wearing a plantar fasciitis boot or night splint, or performing physical therapy exercises that target the plantar fascia? This may provide short-term relief from the symptoms of pain, but it’s equally, if not more important to give your foot some rest by halting all forms of exercise and spend as much time in a state of deep relaxation.
Plantar fasciitis may go away if one can allow the parasympathetic nervous system activity to rise so the muscle tissues may heal and the immune system stays healthy. Removing all forms of stimulation before bed is paramount to allow a deep and restful sleep for the body to regenerate so that the plantar fasciitis may heal more quickly.
Unlike the isolated physical therapy exercises for plantar fasciitis, employing Functional Patterns corrective exercises that address the body as a system, like the hamstring retention exercise or contralateral step row and press, will challenge and train your plantar fascia in an integrative fashion in contexts similar to when you are running.
References
- Myers, T. M. (2009). Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists.Churchill Livingstone Elsevier.
- Sapolsky, R. M. (2004). Why Zebras Don’t Get Ulcers. Holt Paperbacks.
- Weissman, D. G., & Mendes, W. B. (2021). Correlation of sympathetic and parasympathetic nervous system activity during rest and acute stress tasks. International journal of psychophysiology : official journal of the International Organization of Psychophysiology, 162, 60–68. https://doi.org/10.1016/j.ijpsycho.2021.01.015
