Why Does Your Heel Hurt?
If you are experiencing:
- pain in your heel that seems to be slowly getting worse,
- discomfort in the arch of your foot
- tenderness in your heel that is more predominant in the morning or
- your heel is swollen
…you may be dealing with Plantar Faciitis.
This is a very common heel issue that results from excessive stretching of the soft wide band of tissue (plantar fascia) and tendon that runs from the heel bone, across the arch of the foot and connects into the forefoot. Plantar faciitis pain can range from slight discomfort to very debilitating and is usually worse in the morning or after long periods of sitting. In both cases, the foot has rested and the fascia has shortened due to lack of use.
Other symptoms include pain that radiates from the base of the heel into the foot arch or tenderness on the sole of the foot and inside of the heel when pressure is applied inward.
What Causes Plantar Faciitis?
Plantar faciitis begins when the arch of the foot becomes stressed or injured through overuse or repetitive motions in the foot. It can occur as a result of playing sports, or engaging in activities such as running, jumping, or dancing. These actions can cause stress to the instep, which is responsible for providing support when you are standing and allowing shock absorption during movement. The stress can cause the fascia and tendon to thicken and become inflamed and painful, usually at the heel bone where the fascia/tendon attaches.
Recent research also suggests that inflammation may not be a prime cause of plantar faciitis. Instead it is thought to be the result of degeneration of the tissue due to overuse or aging.
Other causal factors of plantar faciitis include:
Overpronation – overstretching of the plantar fascia due to the foot rolling in or over-flattening during normal activities
High arch (pes cavus) – which causes an inability to absorb shock or conform to standing on the ground
Wearing Poorly Fitting Footwear – rigid or unsupportive shoes can increase likelihood of foot damage and injuries
Being Overweight – puts excessive stress and load on the foot and heel
Tight muscles – in hamstrings, calf, hip or gluteal muscles cause imbalances and unnatural foot placement which strains the plantar fascia.
Overtraining – can overstretch or injure fascia especially without proper warm-ups and cool-down practices
Plantar Faciitis and Massage
In addition to possible electrotherapy (ultrasound), deep tissue massage is a particularly effective treatment for plantar faciitis. The concentrated pressure on the fascia, heel tendon, gluteal muscles and hamstrings and especially calf muscles helps release tension, breaks down any scar tissue and supports the detoxification of muscles. As well as, it improves circulation to the affected areas.
NOTE: Contraindications for deep tissue massage include: broken skin in the area, post surgery, osteoporosis, and history of blood clots.
Other treatments to help heal plantar faciitis:
- reduce pain and inflammation through rest, ice, compression, and elevation
- tape the affected area for additional support during activities
- wear protective footwear (possible use of a night splint)
- use plantar fascia and calf stretching exercises (such as rolling foot over a ball)
- have surgery to cut some of the plantar fascia fibres in order to reduce stress. This is a last-resort treatment when all others are not successful.
Prevention:
Embracing regular practices that maintain foot wellness can go a long way to keeping the fascia functioning optimally:
- In any training situation (especially running), increase intensity and length gradually.
- Have a complete biomechanical assessment of your feet to assure proper functioning.
- Take the time to choose and wear correct footwear that provides adequate support. Replace sport shoes regularly.
- Before any activity, make sure to stretch the plantar fascia and calf muscles.
- After any training activity, especially if you have been away from it, use ice to prevent inflammatory issues before they increase.
- One of the most effective ways to prevent Plantar Faciitis is to commit to having regular sports massage. This can support supple muscles in the foot, calf and can maintain good fascia health in the lower extremities.