Plantar Fasciitis can be extremely frustrating and can hang around for a long time if you are not careful. The key to success is to identify the driver behind the problem. Is the area painful because of overuse and needs massage or treatment? Or does the area actually need strengthening?
No two feet are the same and we should look at them in their own right, informed by a full body assessment and factoring in the situation that the pain occurs in.
I worked with a runner recently who was suffering with Plantar Fasciitis. He had been massaging, stretching and was now looking at pain killing injections.
When we did our assessment and watched him walk we found that his foot was stuck in a Pronated position. The rear foot was rotated in, plantar flexed and everted, the forefoot was rotated out, dorsi flexed and inverted. This should happen during our Suspension phase of gait when we bear our weight fully on to one leg as we drive off the other leg.
A fully pronated foot maximises the surface area of the foot before the tissue elastically "catches" and shortens as we start the process of propelling weight to the opposite side.
If you are running outside during the winter, chances are the ground is quite wet and potentially unstable. In this case it is advantageous to maximise the surface area of the foot, to give you the best chance of achieving a grip underfoot. As the ground is unstable, it is likely you will also be unable to maximise the opposite propulsion phase, or drive off, from the leg when you push back.
This leads to a reduction in the contraction of the plantar surfaces of the foot. If the Plantar Surface does not contract fully then it's ability to contract is likely to reduce.
So instead of lengthening, massaging or stretching the Plantar Surface further we looked at shortening it and strengthening it by introducing supination exercises.
By creating supination in the foot we strengthen and shorten the plantar fascia to ease the pressure on the tissue. With follow up exercise this caused a dramatic reduction in pain and symptoms.
Don't just look at the injury; look at the mechanism of the problem, the environment the problem occurs in and why that might be happening.
Always ask "Why is this here?"