Updated: Dec 15, 2021
Hey Dr. McNamara here at McLaughlin Care, and I'm coming at you with a Wellness Wednesday. Today I'm going to talk about a very common foot pathology that causes pain known as plantar fasciitis. Now plantar fasciitis is prominent in about 50% or about 200 million Americans on a yearly basis. And about 10% of individuals throughout their lives will also experience some sort of plantar fasciitis pain.
So what the plantar fascia is is it is a sheet of fascia, which is tissue it's contractile tissues in our bodies; and it connects from these metatarsal heads over here into our calcaneus over here, which is that heel bone. Now, many people that have this condition, they'll complain of pain in their heel, mostly upon waking up or just in that bottom of their foot.
And it'll get better throughout the day, but they'll notice it they're sitting for a while and then they stand up again. It puts a little strain on that fascia and causes some of the pain. So how do we treat that here at our office? Well, the first thing we need to do is we need to remove the symptoms of pain as much as possible.
So the individual can begin exercise comfortably, and we do that with different mode modalities. We'll do some sort of soft tissue release because this is contractile tissue. So that soft tissue release will help relieve those symptoms. And that tightness in the bottom of the foot, we also may work on the calf muscle as it goes down and inserts into that Achilles tendon into the posterior aspect of the calcaneus, which also pulls the calcaneus back tensing that fascia.
So we'll do both those muscles with soft tissue therapies, we may use things such as cupping and maybe a little bit of Kinesio tape just to support the joints around the ankle and the foot. And we also give you some homework. One great tip you can start doing today is if you have a tennis ball or golf ball is before you go to bed at night and early in the morning, if you massage your foot on it, that'll help loosen up that fascia and help relieve some of those symptoms a little bit faster as well.
You may get a little snap crackle pop, so your foot that's totally normal. But the thing after we remove the pain, the most important thing is to remove the stress which causes the plantar fascia. And that has to mostly do with this mechanism.
And it's a great description of it in this paper titled, Plantar Fasciitis and the Windlass Mechanism, a Biomechanical Linked to Clinical Practice. So this goes in great detail of explaining the actual function of the plantar fascia and really in short, what it does is it transmits force that comes through our heels. We walk through our gait and it transmits it to the front and the back of the foot to relieve a strain on the foot so it doesn't collapse or anything like that.
Now with improper biomechanics, poor intrinsic and extrinsic muscular control of the foot and ankle, we start to lose arch and I was born with pretty flat feet, as you can see. And my right foot is a little bit better in shape than my left foot. You can see this big bump, I don't know if you can see it in that video.
There's a huge bump relative to my right foot on my left. And that's due to this constant pronation of this ankle, actually putting stress on a muscle that inserts into this bone called the navicular bone. And that muscle is called the posterior tibialis. So to rehab and gain control of that foot, we perform certain exercises, different types of wobble board, proprioceptive stuff, but one of the main ones that I want to show, and it's just to build control and it's hard to do yourself, but I teach it in the office all the time is what's called short foot. And what you do is it takes a lot of focus and you squeeze those metacarpals towards that calcaneus using that intrinsic and extrinsic musculature of the foot.
So I don't know if you could see, but you can see my hand shorten a little bit as my foot shortens. And my left ankle is a good example to compare because I do have this dysfunction. I'm trying to shorten it and I got a little bit, but when you compare it to my right foot, I just got a lot more control, in my right foot there's no symptoms versus my left foot every once in a while, that gets flared up.
And many of you runners take a look at your foot. If you have this bump, you may notice that sometimes you get pain along the inside of the ankle as well. That's another sign that you should probably get that checked out before it develops into any sort of plantar fasciitis or Achilles tendonitis.