plantar fasciitis question

Discussion in 'Ask the Docs' started by Barefoot Shaky, Aug 30, 2012.

  1. Barefoot Shaky

    Barefoot Shaky Barefooters
    1. Georgia

    Joined:
    Jul 31, 2012
    Messages:
    8
    Likes Received:
    1
    I'm fairly new to running period, very new to barefoot running. A few months ago a started getting pain in the bottom of my left foot. Internet research leads me to believe its plantar fasciitis. When I run barefoot I don't have this pain. I just can't run far yet so I still run some with shoes. Today, I ran a mile barefoot with no problems. I then ran 2.5 miles with shoes. When I put my shoes on and started running I had instant pain, so I ripped out the sole inside the shoe (Adidas Cross trainer) and had no more issues other than trying to keep my barefoot form. Are the shoes causing me to strain my arch? How? What are some good exercises to strengthen the arch? Thanks.
     
  2. Dr Emily Splichal

    Dr Emily Splichal Barefooters

    Joined:
    Aug 30, 2012
    Messages:
    61
    Likes Received:
    54
    Great question! The classic symptoms of plantar fasciitis is pain in the bottom of the heel or arch after a period of rest. Pain is typically described as sharp and radiate behind the heel into the Achilles tendon or forward into the middle of the plantar fascia.

    I see many runners with plantar fasciitis - and they are almost always shod runners. Although there are many theories, I believe the high rate of plantar fasciitis in heel strikers is due to the inability to absorb ground reaction forces which stresses the plantar fascia.

    When you are running barefoot or minimalist your foot is able to pre-contract to prepare for foot strike and is more efficient at absorbing ground reaction forces. It is almost like the plantar fascia is pre-loaded when you strike the ground with a barefoot pattern vs. with the heel strike pattern.

    For you, the most important thing right now is to control the stress to the plantar fascia by stretching the calves and strengthening the foot. There are two types of foot exercises you want to do: concentric and eccentric.
    One of my favorite concentric exercises is to put a ball between heels and below the ankle bones, rise onto the toes while squeezing the ball between the feet.

    The eccentric exercises I like are eccentric calve raises and walking backward on a treadmill.

    Another great trip is standing on golf balls! We have 19 muscles on the bottom of the foot that need recovery and TLC just as much as our other muscles!

    Good luck!
     
    NickW and Barefoot TJ like this.
  3. NickW

    NickW Guest

    Hi Dr Emily, I don't mean to piggy back off of this thread by barefoot shaky. I have plantar fasciitis myself and have been fighting it for close to a year. I've rolled on foam and pvc rollers, stretched, and massaged, all with temporary relief in which the pain would return worse sometimes. I have a theory as I seem to maybe have figured out my own problem (don't really want to jinx myself) that this quote of yours above touches on. For the last week I've really been working on landing just slightly more forward on my foot and focusing on barely letting the heels touch the ground while walking and running. It's amazing, but the heel pain is nearly gone in just a little over a week. I have also added in some leg exercises such as squats, one legged eccentric heel drops, etc... I was not sure what was giving me the relief finally, but after reading that quote of yours above I really believe that it was me banging my heels on the ground too hard which stressed the plantar fascia. Is it possible that this is a fair assessment?
     
  4. Dr Emily Splichal

    Dr Emily Splichal Barefooters

    Joined:
    Aug 30, 2012
    Messages:
    61
    Likes Received:
    54

    You are right on, Nick! It's not the literally "banging" of the heels that would cause the plantar fasciitis but more the increased vibrations that are caused by the heel strike. These vibrations stress the plantar fascia and achilles tendon. So keep doing what you are doing - especially those eccentric heel raises. Love it!
     
    Sid likes this.
  5. Bill B

    Bill B Barefooters
    1. Canada

    Joined:
    Dec 28, 2012
    Messages:
    369
    Likes Received:
    371
    Another great trip is standing on golf balls! We have 19 muscles on the bottom of the foot that need recovery and TLC just as much as our other muscles!
    Hi Dr. Emily!
    Could you elaborate on the above quoted exercise please? How many golf balls? I am always looking for exercises to strengthen my feet! Thanks!!:))
     
  6. Dr James Stoxen DC

    Dr James Stoxen DC Barefooters
    1. Illinois

    Joined:
    Jun 5, 2011
    Messages:
    58
    Likes Received:
    11
    Hi

    The plantar fascia is not stretchy. According to research it only holds about 14% of the load at plant.

    So why is it sore?

    Lever Model thinkers say it is because the achilles is pulling too hard through the plantar fascia and it is straining it. This is a prehistoric view and hardly useful for most who are looking for long term relief and top level performance from the mechanics. You stretch the fascia and the achilles. What you may not understand is that you cannot improve the loading capacity of a fascia by stretching and if it is a NON CONTRACTING structure then how can you really stretch it.

    Did anyone ever ask this question?

    What if it is overloaded? Would you stretch or impart more strain on an already overloaded structure by static stretching? No way! I never stretch the plantar fascia with a patient with plantar fasciitis.

    I sometimes look at doctors and healers as mechanics who dont understand the true mechanics of a region so when all else fails.... STRETCH That will wipe out the 15 minute procedure code and you look kinda cool doing it. That is a mechanic and not an engineer.

    What none of the research experts or those who write about the plantar fascia ask is the MOST important question

    If the plantar fascia only holds 14% of the load at plant what are the other structures that hold up the other 86 % of the load?

    If those other structures are not doing their part to suspend the load off the plantar fascia then they are what needs to be approached.

    The plantar fascia does not stretch much so when the foot pushes off the ground the arch actually MUST elevate by articulating (joints move) to allow it to raise up to allow the foot to push off without stretching the plantar fascia beyond its yield point or plastic deformity or tear point.

    CHECK AND RELEASE THE ARCH SPRING MECHANSIM
    So a good place to look for potential stress on the plantar fascia is the intersegmental motion of the metatarsal cunieform joints. That is the middle of the arch area between the longer toe bones and the mid foot. Bend each long bone back and forth while you hold the bones it bends from in the mid foot to see if any of them are stuck. I call this the "wiggle" test You wiggle the bones to check the joint play and you wiggle them lose if you find they are stiff or locked. Then to keep them moving I recommend running in zig zag patterns, figure 8 patterns, side shuffle patterns and circle patterns as this mobilizes the 33 joints of the foot and ankle naturally as your foot lands on these angles. I run this way and I never have foot pain.



    CHECK, RELEASE AND STREGTHEN THE ARCH SPRING SUSPENSION SYSTEM MUSLCES (LANDING MUSCLES)
    What doctors and scientists elude to is a structure that suspends the arch complex over the fascia. It is my expert opinion that the load of the foot plant is suspended off the plantar fascia by the suspension system muscles of the foot. If you look at the design of the anatomy you will see these muscles have a strategic attachment at the bottom of the foot.



    Introducing the Pronation Supination Cuff Training

    The muscles that prevent over pronation and over supination of the foot consist of the tibialis posterior, tibialis anterior, peroneus longus, and peroneus brevis.

    The strength of these supination and pronation spring suspension are not covered much in bodybuilding or fitness magazines, training routines etc but of all the muscles, in fact these are THE most important muscles in the body to work.

    [​IMG]

    Why?

    • These muscles suspend your foot as a leaf spring so it can bounce your body off the ground instead of bang your body into the ground.
    • They store FREE elastic energy when your mass impacts the ground when they stretch. This storage of energy is what allows your body to move more efficiently as a spring mechanism rather than an inefficient lever mechanism.
    • These muscles, which I also refer to the pronator supinator cuff muscles, maintain the foot and lower limb in the safe range between supination and pronation.

    Most trainers focus on the takeoffs and forget the landings



    The Takeoff Muscles

    Im always browsing the internet and reading books about training and it’s surprising for me to see so many trainers at the elite level talking about the hamstrings, quads, glutes and abdominal core muscles yet hardly ever if any time talking about the muscles which suspend and spring load the arch. No wonder so many have impact related injuries.

    There’s no use planning a fitness regime to rival an Olympic athlete unless you first sort out how healthy or otherwise your gait is. You may be able to fly on the track but it’s not going to take too long before you’re grounded permanently if every step you take is the equivalent of a crash landing.



    Hard landings cause shock to the skeleton, and while it might seem like heavily-cushioned shoes would be the answer, they are in fact, likely doing more damage as they dramatically affect the arch spring’s ability to appropriately absorb, store, then release the energy from each step.

    Rather than strapping five inch ‘pillows’ to your feet, the best solution is to repair the spring mechanism in the arches by following the procedures and exercises in this article.

    [​IMG]

    When your limbs veer outside of the safe range of supination to pronation rolling motion you enter the unsafe range. Any motion of a joint or complex of joints outside its normal range lead to abnormal movement patterns that can cause stress and strain, wear and tear, widespread silent inflammation, which can lead to painful inflammation.


    These muscles must not only be strong enough for us to walk pain free with some energy recycling but also they must possess strength, speed, stamina, suppleness and flexibility.

    When we know how much resistance or impact force the pronation-supination cuff or spring suspension system can resist then we can design the right training program that creates the exact adaptation we need.

    - See more at: Self-Tests & Exercises To Reduce Over Pronation and Over Supination From Impacts During Walking and Running
     
    Line Kolbe, Grant, dutchie53 and 2 others like this.
  7. Spinningwoman

    Spinningwoman Barefooters
    1. United Kingdom

    Joined:
    May 23, 2013
    Messages:
    326
    Likes Received:
    474
    Oh, it's interesting what you say about running figure 8s etc to mobilise joints - when I restarted I was running just in the garden fir a while to avoid the temptation to do too much, and it is such a small area I was doing lots of 8s and small circles and direction changes, so maybe that helped too!
     

  8. Grant

    Grant Chapter Presidents
    1. Canada

    Joined:
    Apr 12, 2013
    Messages:
    26
    Likes Received:
    9
    I have been finding good results with running local woodland trails with tight corners and lots of obstacles and differing surface quality really great for keeping things loose after big runs. Also the kettlebell snatch really makes good use of the spring mechanism as one constantly has to move the centre of gravity from the heel to the toes and back again to execute the move correctly. I find that a 10 min snatch cycle is honestly the best warm-up for me.
     

Share This Page