Fascia
Plantar fascia is indicated primarily by heel pain.
It is an inflammation of the plantar fascia, the muscles that run along the bottom of the foot from from heel to toe. The body is surrounded by a layer of connective tissue that we call fascia. It is responsible for connecting various muscles, tendons, and organs together. In the lower extremities, the two important bands of connective tissue are the Achilles tendon and the plantar fascia.
The Achilles tendon begins below the knee and extends down to the heel. It is an important attachment for the calf muscles and is responsible for plantar flexion (like what happens when you jump or push off the ground when walking). The plantar fascia is a sheath of connective tissue that attaches to the underside of the heel and extends all the way to the toes. Although these these are two bands are separated by the heel (the calcaneus), in actuality they are connected. Therefore, a pain or dysfunction in the Achilles (the the muscles surrounding it) can impact the health of the plantar fascia, due to it taking on more physical load than it otherwise would. And vice versa, pain and dysfunction in the foot can cause pain in the muscles around the Achilles tendon. In addition, the conditions could be on opposite sides of the body. For example, pain on one side can cause the body to compensate by placing more load on the opposite side. Therefore, a problem on one side can result in pain on the opposite side, which can be confusing, because the area of the pain may not be the origin of the problem.
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What causes it?
The most common cause relates to the structure of the foot itself. 81-86% of people who have been diagnosed with Plantar fasciitis have excessive pronation in their feet. Pronation of the foot is normal with walking, and is the lateral movement of the foot that occurs with each step. This lateral movement closes the space between the arch of the foot and the ground, and therefore stretches the plantar fascia. Excessive pronation can happen when a person is overweight or obese (due to a stronger effect of gravity), and/or wearing shoes that do not provide enough arch support. This excessive pronation stretches and inflames the plantar fascia, and also puts strain on the ankle joint, resulting in heel pain.
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What are other symptoms?
People with plantar fasciitis tend to feel the worst pain when they get up in the morning and first put the heel to the ground, or when they have been sitting or long periods of time. After a few minutes of walking and stretching, the pain generally subsides, but can resurface after long periods of time standing.Â
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Who is most at risk?
– Obese individuals
– Middle-aged women
– Work that requires a lot of standing on walking on hard surfaces
– Runners/athletes
– People with either high arches or no arches in the foot
– People who are naturally inflexible
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What are the non-surgical treatments?
Regular stretchingÂ
Try this stretch:(https://www.piedmont.org/media/BlogImages/PlantarFasciitis.jpg)
Step 1 – Cross affected leg over the other leg
Step 2 – grab affected foot and pull toes back towards shin to create tension and stretch arch
Step 3 – hold for a count of 10, do 10 repetitions, three times a day
Consider purchasing a Plantar Fascia stretching boot to wear at night
In addition to stretching the plantar fascia, stretching and loosening the calves and the Achilles tendon will also relive stress on the foot.Â
Avoid going barefoot until you can comfortably walk on the balls of your feet without pain
Wear supportive shoes with good arch support, consider purchasing and using orthotic inserts
Try using kinesiology tape on the calf muscles (https://i.pinimg.com/originals/c8/cd/d2/c8cdd23d30d3adb06be39600dcadbe3f.jpg)
Get regular massage and/or foot reflexology treatments
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Massage Techniques
It’s important to consider the entire chain of muscles when dealing with plantar fasciitis. Even though the pain is localized to the heel and foot, the whole leg is connected by a sheet of fascia, and muscles that are attached in a chain. The following is a list of muscles that are affected by plantar fasciitis, starting with the muscles highest up the leg.
Glutes – the largest muscles of the buttocks has its origin a the sacroiliac joint, and attaches to the medial proximal edge of the femur
Hamstrings – originate at the sit bone of the pelvis and attaches to either side of the knee
 Gastrocnemeous – the larger of the calf muscles, sits above the Achilles tendon
Soleus – the flat, deep calf muscle wedge between the Achilles tendon and the tibia. In plantar fasciitis, there will commonly be trigger points on the soleus along the Achilles tendon
Heel attachments – the Achilles tendon attaches to the back of the heel, and the plantar fascia attaches to the underside of the heel. This is the nexus point where most of the pain is felt.Â
Plantar Fascia – massaging the bottoms of the feet will help stretch, rehydrate, and release the tension in the plantar fascia
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