Plantar Fasciitis Stretching…Really?

Anatomical diagrams illustrating the component...
Anatomical diagrams illustrating the components of the plantar fascia. (Photo credit: Wikipedia)

Plantar Fasciitis, as you may have read several times, is characterized by pain in the heel area after periods of rest, especially when you get up in the morning.  You may have also read that to help alleviate or prevent the pain, you should “stretch the fascia.”  Wait a minute, if plantar fasciitis is the fascia stretching and pulling away from the heel bone. Then why on earth would you want to stretch it?  Sounds like you would create more pain?   Also, some say that it is initiated when you first step on the floor and you get a sudden pull on the fascia.  Those who are really suffering can’t even put their heel on the ground, so how is it suddenly stretching the fascia?  Doesn’t make sense does it?
So why do stretches and splints help some but not others?  To understand, let’s first look at the anatomy of the plantar fascia and the evidence-based research of stretching. 
To my knowledge, there is no evidenced-based research proving that the plantar fascia stretches. The planter fascia is a very thick, fibrous band of tissue (similar to a leather belt) that connects to the undersurface of the heel bone and attaches to the soft tissue at the ball of your feet, including the toes.  It does not connect to any muscles, nor is it a tendon attaching to a muscle. It is also not a ligament that attaches bone to bone.  Therefore, it’s doubtful that this thick fibrous band of tissue stretches.  Anyone who has excess tension or pulling of the fascia will either experience tearing and fibromas (bumps of scar-like tissue) about the fascia or it will tear from the heel bone. Both of these circumstances will inflammation and pain. 
How is it then, that some people indicate that stretching relieves their pain? There are two possible explanations. When the plantar fascia is separated from the heel this causes the area between the tissue and the foot muscles above to be filled with inflammatory fluid. As you “stretch,” the fluid drawn away from this area relieving some of the pain you experienced. Secondly, you are most likely stretching your calf muscles and not the plantar fascia. Since the plantar fascia connects to the Achilles tendon, which in turn connects to calf muscles, they are often connected with the pain you experience. Many people suffer from tight calf muscles. This is often associated with aggravating plantar fasciitis. Therefore, stretching your calf muscles may bring pain relief to the plantar fascia area.
However, plantar fasciitis may also be caused by the degeneration of the plantar fascia tissue. With this type of inflammation, stretching will not alleviate the pain. In this case a foot specialist proficient in biomechanics should evaluate your condition. This is especially true if you have been suffering with the condition for an extended amount of time.
At ArchMasters, we see people who say they have been suffering for nine months, a year, two years, etc.  This pain should not be ignored or allowed to continue.  Seek help to determine the cause and method of treatment needed.
Call and/or stop by ArchMasters today for your complimentary consultation with foot specialist, Dr. Sable.
ArchMasters- Orthotics, Shoes & Footcare, llc. Nashville’s only shoe store with a Doc in every shoebox!
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