Plantar fasciitis is a common condition that we see on our office, but over half of those cases are actually misdiagnosed, with their pain generator being something other than their actual plantar fascia! So let’s break it down a little bit... What is the plantar fascia? Plantar fascia, according to Webster’s medical dictionary, is a very strong dense fibrous membrane located on the sole of the foot that lies beneath the skin and superficial layer of fat, and binds together the deeper structures of the foot. When this fibrous membrane or band becomes irritated and inflamed, it creates pain at the base of the heel, as well as in the arch of the foot.
With that being said, not all heel pain nor pain in the arch of the foot is automatically plantar fasciitis! There are many other mechanisms that cause pain in these areas. The first area of concern when patients come in with these types of pains, is the tibialis anterior. This muscle can become irritated and inflamed if not properly utilized often, and presents as medial instep pain along the arch of the foot. Another big mimicker of plantar fasciitis pain is caused by a small, relatively unknown muscle called the quadratus plantae. This is a deep, stabilizing muscle of the foot, which often can become irritated due lack of proper use again.
Lack of proper use? Well what the heck does that mean? How do I properly use my quadratus plantae?! Simple... take your shoes off, and walk barefoot. Now sometimes this isn't practical, but this is the way our feet are suppose to be! Not caged up in synthetic coffin, like a shoe! (My skeptical, eccentric, but brilliant friend used this analogy and I laugh every time I think about it.) If you are unable to walk barefoot, and struggle with pain on the bottom of the foot we have some suggestions for YOU! A few great exercises for the bottom of the foot that we like to use here at BSSR are:
-2 feet up, 1 foot down: Working on eccentric loading of the musculature and soft tissues on the bottom of the foot, as well as working the gastrocnemius and soleus.
-Janda's short foot: this exercises teaches patients to utilize the intrinsic muscles on the bottom of the foot, increasing the medial arch of the foot in an attempt to re-establish stability.
-Storks: Another exercise working on creating the short foot posture, using a wall to isometrically load the glutes as well (SUCH A BURNER!)
-Vele's leans: this exercise is great for your tibialis anterior and intrinsic muscles on the bottom of the foot, reintroducing control and stability to the anterior portion of the foot.
So remember, move those feet as much as possible! Strengthen and create a support network for your feet so you can do the activities you want to do for many years to come! Walk barefoot, squeeze that medial arch, and have FUN! Having fun while exercising is the best way to create positive change! For instructions/demonstrations on all of these exercises head on over to our Instagram page!