Plantar fasciitis is one of the most common causes of heel pain. The condition was originally thought to have stemmed from an inflammatory process, but researchers are now concluding the causation being a combination of degeneration of tissue, microtearing, and necrosis (tissue death). Plantar fasciitis can be caused by a variety of circumstances that create an excessive load at the plantar fascia insertion at the heel. Contributing factors include a higher BMI, overuse, fatigue, improper training regimen (increasing intensity/duration too quickly), and poorly fit footwear.
Be Mindful of Symptoms
The easiest way to prevent plantar fasciitis is to be mindful of the symptoms. Pain typically occurs during initial weight bearing following a prolonged resting position. The trend is that the pain usually gets better after initial walking and then gradually worsens with increased activity/weight bearing. There are three areas of consideration to prevent and reduce symptoms of plantar fascia pain including stretching, shoewear, and strengthening.
Stretching is important for both the treatment and the prevention of plantar fasciitis. Based on the biomechanics of the foot and ankle, the calf and achilles should also be considered when stretching. This will allow for greater mobility of the ankle and will allow the tissue to functionally tolerate the heel to toe loading when walking. The more range of motion you have, the more time the force has to disperse, thus less force to the plantar fascia. Think about catching an egg someone throws to you. If you don’t move your hand, it will probably break; however, if you lower your hand while catching the egg, it won’t break.
Another consideration is shoewear. Shoes that lack the support required for structural deformities and functional deficits can lead to plantar fasciitis. If you are standing for extended periods of time throughout the day, you may acquire plantar fasciitis. Having appropriate shoewear that supports the foot could prevent the additional stress of the long weight bearing position. Due to the weight bearing component, losing weight may also be a beneficial component to reduce the amount of stress placed on the foot.
In the past, it was often assumed that poor shoewear and a lack of flexibility are the only factors to consider in prevention of plantar fasciitis. However, lack of strength of the foot intrinsic muscles can be a major contributor in the development of plantar fasciitis. The amount of activity we ask of the tissue in relation to the strength it possesses is a major issue. This is where strength and stability come into play. Ensuring the foot and ankle muscle groups have the capacity to support the activity-driven forces is essential. If continuous activity is performed and the foot fatigues repetitively, the plantar fascia will be stressed leading to potential symptoms of heel pain.
Due to the variability in how you can get plantar fasciitis, you must take a multi-directional approach in the prevention of the condition. Proper assessment and an accurate diagnosis of the dysfunction of the foot and ankle are essential to a quick and complete recovery.