Now that Spring has sprung and the weather is getting warmer, we here at Peterson Physical Therapy will start noticing an influx of people coming to see us with foot pain. I have my theories as to why this happens and I will explain them below. But first, let me tell you about the most common foot problem we see, Plantar Fasciitis.
What is Plantar Fasciitis?
Plantar Fasciitis is the inflammation of a thick band of fibrous connective tissue that runs from the heel to the toes. The purpose of the Plantar Fascia is to support the arches in your feet and to absorb shock during weight bearing activities (i.e. walking, running). Excessive stress on the Plantar Fascia can lead to microtears in the tissue where it attaches to the heel, leading to inflammation.
The classic sign of Plantar Fasciitis is a sharp, stabbing pain in the bottom of the foot near the heel when first getting out of bed in the morning or after prolonged sitting. This pain typically decreases as one becomes more active during the day. However, the heel pain can increase with prolonged weight bearing activities such as standing and walking.
Why did I get it?
As I mentioned before, we often see an increase in people coming to see us for foot pain in the Spring and Summer months. I feel it has a lot to do with people transitioning out of their winter footwear and into their summer footwear. In the winter, people generally wear heavier shoes (i.e. boots) that provide support to one’s foot and arch. These shoe types decrease the need for the smaller muscles in the foot to work throughout the day.
Then, in the warmer months of the year, people transition to sandals, flip flops, and other lighter shoes that do not provide the same level of support.Those small muscles are now asked to go from doing very little to doing a lot. The load can be more than the small muscles can handle causing significant changes in the location and the way we carry our weight on our feet.
Additionally, as the weather warms up, people tend to be more active outdoors (i.e. doing yard work, hiking, and recreational activities). Walking on uneven terrain, such as the yard, can inflame the Plantar Fascia in one’s foot, especially after a long winter of being sedentary. Our feet begin taking a beating with the increased activity.
Other Risk Factors
Other factors that can cause Plantar Fasciitis due to added stress to the fascia include:
- Limited ankle range of motion.
- Obesity
- Foot mechanics (i.e. flat feet, high arches, or an altered walking pattern)
- Certain exercises that place excessive stress on the feet (i.e. distance running, basketball, and dancing/ballet)
- Occupations requiring prolonged standing (i.e. teachers and factory workers)
Treating Plantar Fasciitis
Here are some ideas of how to treat your Plantar Fasciitis:
- Apply ice to the heel and bottom of your foot. A good technique is to freeze a water bottle and then roll it back and forth under your foot.
- Foot Orthotics – Peterson PT offers a free orthotic consultation and can get you a pair of custom orthotics if it is recommended.
- Night Splints
- Footwear
- Weight loss
- Stretching: As I mentioned earlier, loss of ankle range of motion can place additional strain on the Plantar fascia. In order to determine if your ankle range of motion is limited, watch this video: https://www.youtube.com/watch?v=oWvQnh_LSw0. If you are limited in your ankle ROM check out the stretches and video links below.
- Strengthening the smaller muscles that support the arch of your foot. See the strengthening exercises below.
Helpful Stretches
- Standing Gastroc Stretch:
- Stand approximately 6-8 inches from a wall with your forearms on the wall.
- Take a normal step back with the leg you want to stretch.
- Ensure the foot is perpendicular (at a right angle) to the wall.
- Keep your heel on the floor and knee straight.
- Lean forward putting your weight onto your forearms and your front leg.
- You should feel a stretch in the back of your lower leg (calf) just below the knee.
- Perform 3 times for 30 seconds, 3 times per day.
- Soleus Stretch in Kneeling:
- Kneel on 1 knee while facing a wall with the front foot approximately 4 inches from the wall (i.e. width of your hand).
- Place your hands on the wall and keep your torso upright.
- Lean forward trying to touch your front knee to the wall without letting the heel come off the floor.
- Ensure the hip, knee, and foot remain in a straight plane.
- You should feel a stretch in the back of your lower leg (calf) just above the ankle.
- Perform 3 times for 30 seconds, 3 times per day.
- Soleus Stretch (Alternative in Standing):
- If you are unable to kneel or get down on the floor you can perform the Soleus stretch in standing instead.
- Set up like you are doing the Gastroc stretch mentioned above with your feet approximately 6-8 inches from the wall with your forearms on the wall.
- Take a small step back with the leg you want to stretch.
- Ensure the foot is perpendicular (at a right angle) to the wall.
- Bend your knees, but keep your heels on the floor.
- You should feel a stretch in the back of your lower leg (calf) just above the ankle.
- Perform 3 times for 30 seconds, 3 times per day.
Strengthening Exercises
- Toe Yoga:
- Sit in a chair with your feet flat on the floor.
- Lift your big toe off the ground while keeping the other 4 toes on the floor.
- Place the big toe back on the floor.
- Lift the 4 smaller toes off the ground while keeping your big toe on the floor.
- Ensure that the knuckle of your big toe stays on the ground the entire time.
- Hold each position for 5-10 seconds and repeat for 10 – 20 reps per day.
- When this becomes easy progress to doing this exercise in the standing position.
- Short Foot Exercise:
- Sit in a chair with your feet flat on the floor.
- Keeping your toes on the floor, pull the knuckles of your foot toward the heel using the muscles in your foot.
- This is a subtle movement, but you should notice that your foot shortens and the arch on the inside of your foot raises off the ground.
- Hold this position for 5-10 seconds and repeat for 10 – 20 reps per day.
- When this becomes easy progress to doing this exercise in the standing position.
- We are available for a free 15 minute phone consultation to talk about how your pain is affecting you and to discuss your treatment options.
- If you are in pain and unsure about what your next steps should be, call us at (301) 539-3807 and ask how we can help.
- Check out our other blogs on Neutral Posture to help get the rest of your body working in unison!
