Pain in the Foot! A look at Plantar Fasciitis

Autumn is here in full force we have survived Octoberfest, and Halloween! These social events put us in contact with new and interesting people. How many of us have been in one of those situations where the conversation not only sucks? But its downright ugly, painfully brutal If you got me on an off day sorry.  When I watch a person move it is a conversation with the world around them, their constant adaptation to different stimuli internal and external allows them to express themselves. While movement can be graceful like a ballet dancer or sprinter in stride it can be downright ugly as well.One of the worst forms of self expression is the knife heel dance that the plantar fasciitis or plantar heel pain sufferers go through every morning or after a long period of sitting. The first five steps are agony, they cannot put the heel down, stabbing pain in the entire bottom of the foot, sometimes going up the leg. This walk of shame can occur everyday multiple times in a day.  At one point I was suffering from plantar fasciitis, as the result of an increase in mileage while being a bit overweight and running in the wrong shoes. It was brought under control through some treatment, trial and error home treatment, and yes I bought into the contraptions. We will speak more about that cottage industry later. Unfortunately 10% of people will suffer from plantar fasciitis in their lifetime with a higher incidence in the athletic population. This is not just a niche problem for the running community the annual cost for treatments is estimated to be between $192 and $400 million a year. The centers for Disease Control and Preventions National Center for Health Statistics has found that plantar fasciitis accounts for 1 million doctor visits per year.  The cost of custom orthotics is between $200 ad $800 per pair and surgery is $10,000.00. This does not even address ongoing cost to the labor force if you are having foot pain and need to be on your feet all day it's likely you are not working that day. Now you can see the importance of the subject, why it needs to be addressed, the ways in which we can all have beautiful conversations.  We will be exploring just that in this article along with some steps you can take to deal with the modern scourge plantar fasciitis. 

So what is plantar fasciitis? It occurs when you overwork the tendons and the thick tissues of the  bottom of the foot. The pain occurs at the bottom of the foot by the heel bone, this was thought to be caused by inflammation but the current theory is that is rather degeneration.  The symptoms of plantar fasciitis are pain in the heel starting gradually ad may radiate to the arch of the foot. Tenderness under the sole of the foot and on the inside the heel when they are pressed on. The pain can either range from discomfort to very painful depending upon the level of damage. The pain is usually worse in the morning as the foot is a relaxed position while we sleep causing the plantar fascia to shorten.The name gives it away in that it’s an inflammation of the plantar fascia of the foot. Leonardo Davinci is quoted as saying “The human foot is a masterpiece of engineering and a work of art.” He may have been admiring one specific foot when he said this, but it does hold true. The foot has 26 bones accounting for a quarter of the bones in the entire body. The foot contains 33 joints, 100 muscles, tendons and ligaments. One of the key players has been left out fascia, leaving us to ponder what is fascia. The simple answer is that it is a thin sheath of fibrous tissue enclosing a muscle or other organ.  Fascia allows the muscles to move freely alongside other structures and reduces friction. It can be found immediately beneath the skin, around muscles, groups of muscles, bones, nerves, blood vessels, organs and cells. The plantar fascia is the muscle and fascial tissue under the foot that forms the arch.  After the first few steps in the morning will lessen or subside. Lets look at the possible causes and risk factors that come into play with plantar fasciitis.   Some of the common causes are repeated stress and strains to the feet where they become to much for the foot to handle. The risk factors are tight calf muscles, obesity, a very high arch, repetitive impact sports, increase in activity ie running, jobs where your on feet for extended periods of time and a faulty walking pattern. 

Over the summer I had to opportunity to visit with a friend through the course of our conversation her fathers “old man” injuries came up. He is a retired gym rat who along  the way acquired some of the more common gym maladies a shoulder issue from regular use, plantar fasciitis and the consummate knee pain. In his day Tom was not a meathead, but given his age that may be the way he trained as that was the trend of the day. As a  fitness community our knowledge base grows exponentially year in year out with nutrition, exercise science and supplementation. When I started working out going behind the head for pushes and pulls was normal, now you have to be a renegade or a dinosaur to train that way.  I volunteered to write Tom a program for his plantar fasciitis as well as talk to him about his other injuries. After I made the offer I thought this needs to be a post for everyone to benefit from. One thing that was uncovered was the fact that Tom had over a dozen contraptions, like me he made the donations to $400 million. I did some research the average contraption cost is $16.99 -$24.99 per item from providers like durable medical equipment companies and online stores like Amazon. My Uncle Moe is very funny man and happens to be very quotable. When all of his kids lived at home he used to look at the phone bill line by line asking who called this number and who hit star 69 five times? “these kids are nickel and diming me to death!”  Moe is right they are nickel and diming people to millions. Lets get back to the hellish groundhog day opening to the plantar fasciitis sufferer. Its 5:45 am the alarm goes off your hear some bongos then the chant the champ is here! The champ is here! The champ is here! Off like a shot out of bed until your feet hit the ground, the champ goes down like Joe Frazier. Pain in the foot gotta get up before the alarm wakes up the rest of the house,  after a few steps the pain subsides alarm is off. Those of your who go through this on a daily basis I am sure you came here looking for solutions please see below. 

Solutions Table Release-Stretch-Strengthen-Reintegrate

While in Bed before your feet hit the floor 

-Point and flex your toes ten times 

-Make circles with you feet ten times clockwise, reverse that ten times 

When your feet hit the floor 

-Have either a golf ball, lacrosse or a hand ball in the night stand 

-GENTLY roll the ball under your feet ten times front to back 

What the above does is gets the tendons and fascia in the feet moving so that there is some blood flow. It also takes the foot out of the relaxed position by slowly lengthening the plantar fascia.

No more barefoot walking in the house, purchase sandals with a thick heel as flip flops and barefoot walking will collapse your arch

This will not be enough to get your Plantar Fasciitis to subside you will need an exercise protocol. Release-Stretch-Strengthen-Reintegrate

Release Foam Roll the Calf Muscles  

Sit in front of a foam roller, put your legs over the foam roller stacking the legs on top,  start at the top of the back of the shoe roll until you find a tender spot. Then relax and breathe hold for 30-120 seconds, then you find another tender spot. 

Stretch 

Calf Stretch Hold the stretch for 30-120 seconds or until the release is felt. Stand feet hip with distance apart, square your shoulders and hips up to the wall, step one foot back, as you keep the heel down push your hands into the wall and hips towards the wall. 

Strengthen or rehab measures: for this you will need a seat, a hand towel, a dixie cup and some marbles. 

Put the towel on the floor(preferably wood) in front of the chair, take your shoes and socks off. Put your foot in the middle of the towel and scrunch it up with your foot. Did I say this would suck? I must’ve forgot to mention that. Switch feet. 

Onto the monkey foot game!!

Take the marbles dump them on the floor around the dixie cup. 

Now your going to monkey foot the marbles into the dixie cup, by picking the marbles up with the toes of the foot and placing them in the cup. 

Repeat on the other side. 

Reintegrate

This one is really simple Farmers Carry. If you have access to kettlebells they are preferable to dumbbells, use what you have access to.  You will want one bell in each hand the weight should be substantial enough that you have to work to walk with it. The key is going to be walking through the feet this should give you a grounded feeling.  The farmers carrys are great because they will strengthen the feet as well as work on your gait to some degree. 

Bonus Track

My favorite albums have bonus tracks. This is your bonus track for this article, while it may not be The Clash’s Train in Vain. It should help you if your in pain and can’t seem to shake it. All you need is a round water bottle thats frozen solid. Basically with your sock on you roll the frozen water bottle under your foot this will provide some temporary pain relief. You will need to use some of the Release-Stretch-Strengthen-Reintegrate protocol as stated above. Otherwise you are only managing a symptom not the whole issue. 

The above solutions have worked well for me, I am a health and fitness professional but I am not a doctor. So the solutions that are posted here are limited if you are still in pain not getting better it may be time to seek out a professionals opinion like a physical therapist, chiropractor and or a physician. As they will be able to do some manual muscle tests, gait analysis and other tests to diagnose you. One of the ideas as far a training and what I look for in medicine is to treat the whole disease or issue and not the symptom. When dealing with an engineering masterpiece like the body or foot we all want a comprehensive approach with better results. As we age we should all be interested in moving like a dancer with grace, like a boxer with balance, a sprinter with explosive power and a child moving with ease.  In the coming months we will have a holiday primer to help you survive the holidays in shape, a look at working out with spinal injuries, and unconventional training. Please read and share this article and any of the others you like on my site.