When it comes to foot pain, many people get expensive orthotics and hope everything will be ok. Unfortunately, in most cases, the orthotics alone are not a cure. In order to understand how most foot pain starts, it is important to have a broad understanding of the foot anatomy and its bio-mechanics.
Most foot pain is located either on the bottom of the foot, the heel or on the outside of the foot. Even if pain is felt in different locations, they usually have one common origin: Stress on the Plantar Fascia.
Connection between The plantar fascia and all the muscles of the posterior leg.
So to summarize the hamstrings run along the back of the tight, down to the knee. There they connect to the calf muscles that turn into the achilles tendon which attaches to the heel. Here, it connects to the dense ligaments like structure called the Plantar Fascia, which supports the arch of the feet. Also supporting the arch of the feet are the small intrinsic foot muscles. Now in a perfect world, if these muscles and Plantar Fascia are healthy and loose, this design works perfectly. Unfortunately this is often not the case.
What is Plantar Fasciitis and how does it begin?
Plantar Fasciitis is when the plantar fascia ( ligament like structure that support the bottom of the feet) becomes irritated and inflamed. The irritation can be caused by many factors:
If the calf muscles and hamstrings are really tight, it will pull on the achilles tendon, which will pull on the plantar fascia, making it really tight. When the Plantar Fascia is tight, it loses it’s ability to slightly stretch when weight bearing. This causes the tissue to develop mini tears with every step. These mini tears will cause inflammation and pain in the Plantar Fascia. Once this initial flare up calms down, the mini tears will start healing with the development of scar tissue. Since scar tissue has no ability to stretch at all, this build up will cause the Plantar Fascia to become even tighter and more rigid. As the plantar fascia progressively loses it’s ability to give slightly during weight bearing, a micro tearing scar tissue development cycle will develop and the pain will progressively get worse.
Weakening of Intrinsic Foot Muscles
Another cause of Plantar Fasciitis is the weakening of the intrinsic foot muscles. This can be caused by both wearing over supportive shoes and wearing under supportive shoes. Both are very common causes of weak intrinsic foot muscles.
Over supportive shoes will support the feet so much that the small intrinsic foot muscles barely have to work to support the arches and maintain balance. Since the muscles don’t have to work as much, they eventually get lazy and become very weak. Remember, if you don’t use it, you lose it! Since one of the 2 structures that support the arches are now very weak, all the weight of the body has to be supported by the other; the Plantar Fascia. Although the Plantar Fascia is very strong, it was not designed to support ALL the body weight and therefore, it gradually stretches, tears, becomes inflamed and develops scar tissue. This commonly happens when people switch from shoes and boots to sandals and flip flops in the summer.
Under supportive shoes usually becomes a problem for people who stand for prolonged periods of time. When standing, the small intrinsic foot muscles are constantly working and like all muscles if overworked, they become tired and eventually weak. This fatigue and weakening of the foot muscles will cause a increase in strain on the plantar fascia, because once again, it has to take over the entire task of supporting the arches. Slowly the Plantar Fascia will stretch, tear, become inflamed and the arches will collapse over time. This is where Supportive orthotics are VERY useful.
A regular routine of massage therapy can be a useful tool in managing foot pain and restoring the planar fasciitis to good health.