Plantar fasciitis (PF) is often a blanket diagnosis for foot/heel or arch pain. The common approach to treat this condition is ice, rest, stretching the calf and wearing a night splint that passively stretches the plantar fascia. The next phase in treatment is wearing custom orthotics and cortisone injections. Some of these interventions may provide some relief, in my experience they provide limited benefit.
Foot and ankle pain is often the end result of poor biomechanics throughout the whole movement system: spine, hips, legs and feet. Every time your foot hits the ground (running) a force 2-3x your body weight gets transmitted up through your body. The alignment of your bones/joints as well as the health and function of your soft tissues like ligaments, tendons and muscles determine how well that force is absorbed or dissipated. People with PF often have deficits in all these areas: poor joint alignment, weak muscles, compromised ligaments and poor movement efficiency (ability to absorb and generate force).
The picture above illustrates severely pronated feet (possibly genetic since it is bilateral), without an arch the foot can’t effectively absorb force or react very well to surface conditions. I often see some degree of ankle pronation with PF. A thorough evaluation of the hips/legs as well as gait analysis is essential to identify where the dysfunction is stemming from.
In all PF cases I treat I teach self massage (address fascia pain) and use corrective exercises to re educate muscle function to ensure optimal joint alignment. In addition to reduction in pain runners and athletes often see an improvement in running function.
