If you feel a stabbing pain between your heel and the toes during the first tentative steps after waking up, you might have plantar fasciitis. Now the name might not be commonly known, but speak with physios and this is one of the easier syndromes to detect. Most will agree that such are the symptoms that if someone has plantar fasciitis, they already know. Awareness is also related to the intensity of discomfort and how quickly easy-to-do stretches and rolling can help the pain subside.
“The plantar fascia is a strong, fibrous attachment (similar to a ligament) that runs from your heel to the ball of your foot and your toes. It's stretchy like a thick rubber band. The plantar fascia connects the bones in your foot together and forms the arch on the bottom of your foot. Plantar fasciitis happens when your plantar fascia is overused or stretched too far. This inflammation makes it painful to walk or use your foot,” states an article on the subject on the Cleveland Clinic website.It adds that most people experience this pain in one foot at a time.
The thing about plantar fasciitis is that while it can go away as quickly as it was felt, and sometimes even on its own. However, it is not the easiest to permanently treat and it has a tendency of coming back. “In some cases, a heel spur may be found. Plantar fasciitis is not easy to treat and patient dissatisfaction is common with most treatments. The majority of cases are managed non-surgically but recurrence of pain is frustrating,” states a research paper, Plantar Fasciitis published in the National Library of Medicine.
Ending the discomfort in the long run needs consistent work on an area of the body you simply have to use all the time. Which means rolling your foot over a tennis ball or getting ultrasound treatment in the heel area can bring you relief, but not a cure. I felt some pain in my right foot and immediately thought it was due to fatigue after a busy week of playing football with friends. A few smart searches later, I did a few stretches (as in the video below) and would be able to manage the pain but it would never entirely go away.
And this is where looking for the cause of the injury becomes important. One of the videos I was watching, posted by the widely followed E3 Rehab channel on YouTube, spoke about capacity and load, and how it was like a see-saw, especially when it came to supporting a body on two feet.
Given that I was recovering from an adductor strain on the left side, it seemed logical I was overloading the right side of my body. Which probably meant until both sides had the capacity to bear the load of my activities equally, there would be no respite from the heel pain. The video also cited an important study titled, High-load Strength Training Improves Outcome In Patients With Plantar Fasciitis.
It concluded that “a simple progressive exercise protocol, performed every second day, resulted in superior self-reported outcome after 3 months compared with plantar-specific stretching. High-load strength training may aid in a quicker reduction in pain and improvements in function.” The study also included a 12-month follow-up before it published the findings.
So it had to be stretching and strengthening, and the video above shows you an exercise for each. The strengthening exercise seems like a slow heel raise but with added control and a towel placed under the MTP joint (metatarsophalangeal joints), holds at the isometric, and makes sure you slowly overload with a backpack or light dumbbells before heavier weights.
A video by Physiotutors says that this is the “best exercise” for plantar fasciitis treatment and recommends three sets of 12 repetitions every other day for a couple of weeks. This exercise is incredible because it “causes tensile loads across the degenerative tendon and yields better results than daily plantar specific training.”
There are a few tests you can put yourself through to understand where your plantar pain originates from. If your calf on the same side is not tight then it is almost certain that the cause is somewhere else. Being equipped with this knowledge before heading to a physiotherapist will help you make the right choice when it comes to treatment. Because just like any other injury, this one needs not just stretching, but also strengthening.
Pulasta Dhar is a football commentator, podcaster and writer.
