Of all the fasciitises (fasciiti?), plantar fasciitis is, well, it’s the only one you really have to worry about. Anecdotally associated with the obese and pregnant, it’s foot pain and tightness common among all walks of adult, particularly those between the ages of 40 and 60. But it’s impo rtant to know that you’re unlikely to take a wrong step and suddenly catch plantar fasciitis. “Plantar fasciitis can happen acutely with heavy use, but it’s more common for it to happen progressively, over time and chronically,” says Paul Schroeder, MPT, CSCS, C-PS, founder and lead physical therapist at Fast Track Physio in Chicago, Illinois. Habitual runners, dancers, athletes and people who work on their feet are at heightened risk, but we’ve all got about a 10 percent chance of experiencing plantar fasciitis at some point in our lives. That doesn’t mean, however, that there aren’t steps we can take to lengthen those odds. We spoke with Shroeder on the risk factors and remedies associated with plantar fasciitis. Below, he shares stretches, exercises, and myofascial therapy options to manage the condition if you have it or prevent it if you don’t. What is the plantar fascia? The plantar fascia is a band of connective tissue along the sole of your foot that spans from the bottom of your heel to the base of your toes. It provides structure and weight-bearing support, helping propel you forward during walking, running and dynamic movements. Schroeder offers the humble bridge as an analogy: “Its construction is based on an arch because it offers ideal force distribution. Same thing with the plantar fascia. You use the muscles of your foot and ankle to propel yourself forward and express energy in whatever direction you want, but you need that medial longitudinal arch of the foot in order to maximize efficiency and mechanics.” So although the plantar fascia isn’t contractile tissue (i.e., muscle), it can tighten up. Taken to an extreme, that tightness can advance to plantar fasciitis which, much like anything that ends in “itis,” is an inflammation or degeneration of this tissue. Anatomical diagrams illustrating the components of the plantar fascia. Image: Public Domain Causes of plantar fasciitis When tension on the plantar fascia consistently exceeds its capacity, micro-tears, inflammation, tightness and pain can result. This, according to Schroeder, most commonly arises from repetitive use (i.e., chronically) rather than from a single event (acutely). “Usually in these situations there is an acute-to-chronic workload spike,” which describes a sharp change in demands placed on the plantar fascia, often introducing unfamiliar stimuli. “It usually involves three or four different behavioral patterns or a combination of these things.” Unsupportive footwear Wearing flip-flops, minimalist sneakers, worn-out shoes, ballet flats or high heels. Barefoot walking There’s no footwear more unsupportive than no footwear. Increased load A start or change in fitness routine, work that involves prolonged walking and/or standing, or recent weight gain. Tricky terrain Routinely walking on rocky, unsteady and/or uneven surfaces. Arch issues Physiologically flat feet on one end of the spectrum, or high arches on the other. Symptoms of plantar fasciitis “It’s usually not a matter of if but when the chronicity of that cumulative microtrauma catches up with you,” Schroeder says. Here’s how it manifests. Pain You might have experienced a mild form of plantar fascia tightness upon taking your first step out of bed this morning. If the fascia constricts overnight, it can result in a brief, debilitating flash of pain and stiffness when planting your foot on the floor. If that feeling persists, the issue may rise to the level of plantar fasciitis. Tightness Microtrauma to the plantar fascia may result in tightness that spreads to the muscles in the foot on up the posterior chain to the calf. Sometimes, plantar fasciitis can even affect muscles up into the hip and low back. “The human body behaves, in many ways, like electricity or water in that it will find the path of least resistance to achieve a certain outcome,” Shroeder says. When you have arch inflammation and/or tightness, the muscles in your foot can’t operate as efficiently. You may, in turn, compensate by using your calf, which has plenty on its plate already. Consequently, those calf and smaller stabilizer muscles become overworked and inflamed themselves, exporting the tightness and pain upward. Tips for preventing and managing plantar fasciitis Schroeder offers three tips to avoid stress on the plantar fascia that are, ironically, also the ways in which you develop it. “This is management, but this also speaks prophylactically,” he says. Monitor your soles Periodically check your shoes—particularly the bottoms. If they’re wearing thin, toss ’em. Rule of thumb, according to Schroeder: Depending on your level of activity, body weight, and the surfaces on which you traffic, expect to get 350 to 400 miles from a pair of shoes. “Visually inspect the sole and, once you start seeing wear and breakdown and the grooves are starting to merge together, that’s the point at which this sole is probably doing more harm than good,” Schroeder says. Take stock of your terrain Where you walk and run is as important as how much of each activity you do, so make sure you’re conditioned for your conditions. If, for instance, you’re accustomed to taking long walks on level ground and find yourself on a hike in the hills, be mindful of the difference in topography and economize accordingly. Same goes for a vacation at the beach, where you might spend a week or two on the sand wearing flip-flops or no footwear at all. “In cases like that, you don’t have any external support to that medial arch of the foot and you’re going to sustain more load with each step,” Shroeder says. “You want to monitor the amount of unlevel terrain and/or inclines and declines that you walk because that really seems to spark fasciitis.” Prioritize footwear A large number of the plantar fasciitis cases Shroeder has seen are the result of clients plodding around in cheap shoes, worn-out shoes or no shoes at all. “I think this [tip] is perhaps most overlooked, but [it’s] wearing supportive footwear and not being barefoot while at home so you can have that increased support and protection from excessive ground reaction force,” he says. “That’s not to say, ‘Don’t walk barefoot, you’re going to get plantar fasciitis.’ It’s usually not just one thing but a constellation of factors that are going to cause repetitive microtrauma.” 6 Plantar Fasciitis Stretches and Exercises for Management and Prevention As with many matters musculoskeletal, the length of time it takes for plantar fasciitis to develop may resemble the amount of time it takes to correct it.  “So if something took a year and a half to onset, I’m not saying it’s going to take a year and a half to fully resolve, but don’t expect it to resolve in three weeks.”  Shroeder also has three guidelines for management of plantar fascia: Pre-loading stretching. Lengthen the plantar fascia yourself before your environment gets a chance to. Strengthening the foot intrinsic muscles. A level deeper than the fascia, these help form the arch. Consistent stretching of the leg muscles. Tightness in your foot leads to increased stress up the chain. 1. Pre-loading plantar fascia stretch in bed This stretch helps relieve tension, improve flexibility, and increase blood flow to the affected area. Before you get out of bed in the morning, sit on the edge of the mattress, and place your right ankle on your left thigh just above your left knee. Holding your right ankle in your right hand and your right toes in your left hand, gently pull your toes backward until you feel a stretch along the bottom of your foot. Hold for 20 seconds and repeat three times for both feet. Images: Stanley Horaczek / Popular Science 2. Plantar fascia massage This massage increases blood flow to the plantar fascia, which promotes healing and reduces pain. It’s recommended in conjunction with stretching exercises. Sit in a chair or stand with one foot resting on a small ball or frozen water bottle (ice helps reduce inflammation). Starting at just below the ball of your foot and ending just before your heel, slowly roll the ball/water bottle forward and backward. Perform 10 complete rolls on each foot, doing two sets per foot. Image: Stanley Horaczek / Popular Science 3. Heel raise Heel raises help strengthen the calf muscles, which in turn support the plantar fascia, reducing pain and improving overall function. Stand with the balls of your feet on the edge of a step. Grab a stable object nearby for support, if needed. Slowly lower your heels until you feel a stretch in your calf muscle, and then slowly rise back to the starting position. Perform 10 reps, then rest. Complete two sets. Images: Stanley Horaczek / Popular Science 4. Ankle inversion with resistance This exercise helps improve mobility and reduce stiffness, strengthening the ankle muscles, bolstering stability and enhancing overall foot function. Note: Avoid hip movement during this exercise.  Sit upright on the floor with your legs extended straight in front of you, and secure a resistance band around the ball of your right foot Holding the band in both hands, cross your left leg over your right leg, pressing the bottom of your left foot against the band. Keeping your left foot still, slowly rotate your right ankle inward and return it to the starting position. Repeat for 10 reps, completing two sets per foot. Image: Stanley Horaczek / Popular Science 5. Toe towel scrunches This exercise strengthens the intrinsic muscles of the foot, supports the arch, and reduces tension on the plantar fascia. Stand or sit upright in a chair, placing your right foot on a towel and spreading your toes. Curl your toes to scrunch and draw the towel toward you. Perform 10 to 15 reps, completing two sets per foot. Perform 1-3 times daily. Optional: As you get stronger and this exercise gets easier, you can place a small weight (2 to 4 lbs.) on the far end of the towel to intensify it. Image: Stanley Horaczek / Popular Science 6. Wall-facing calf stretch This stretch helps alleviate tightness and improve flexibility in the calf muscles, reducing symptoms associated with plantar fasciitis. Two versions target two different calf muscles. Gastrocnemius (straight-knee) version:  Stand upright facing a wall at arm’s length, place your hands flat on the wall, and extend your right leg behind you. Keeping both feet flat on the floor and your right knee straight, bend your left knee until you feel a stretch in your right calf. Hold for 20 seconds and repeat three times with both legs. Soleus (bent-knee) version:  Stand upright facing a wall at arm’s length, place your hands flat on the wall, and extend your right leg behind you. Keeping both feet flat on the floor, bend both knees until you feel a stretch in your right calf. Hold for 20 seconds and repeat three times with both legs. Perform each version 1-2 times daily. Images: Stanley Horaczek / Popular Science The post 6 stretches to relieve plantar fasciitis pain, according to a physical therapist appeared first on Popular Science. ...read more read less