Plantar Fasciitis – What Causes It, Why It’s Happening and What to Do About It
Are you ready to Break Up With Your PF™?
Plantar Fasciitis, that is.
If you do – first, you have to understand what it is and what’s causing it.
I put “injuries” in quotations because (and this is why this issue seems to confound western medical science), there’s often nothing structurally wrong (visible to imaging machines or other diagnostic methods) to point to as the cause of pain.
There are no broken bones, nearby joints probably looks ok, and usually there’s nothing ‘wrong’ with the soft tissue either (other than inflammation), from a western medical standpoint. There might be a heel spur, or minor tearing of the plantar fascia itself – but this is often looked at in a vacuum as the cause and site of pain when it’s actually a symptom of something else.
Without knowing the cause of something it’s almost impossible to know the solution.
Any attempts to eliminate pain without first knowing the cause is like throwing darts at an unknown target in the dark! The chances of hitting the correct target are next to nil.
If you’re ready to say goodbye to plantar fasciitis and hello to happy feet, click here. If you want to understand it more first, keep reading.
What IS plantar fasciitis?
Traditionally, plantar fasciitis is described as “heel pain,” but people are often diagnosed (or self diagnose) with plantar fasciitis whether they have pain in the heel UNDER the calcanues (heel bone) on the bottom of the foot, on the inside or outside of the heel NOT on the bottom of the foot (so, below the inside or outside ankle), whether the pain is in the arches and sometimes PF can be classified as pain under the ball of the foot.
While these details may not matter for a diagnosis (and I am NOT in the business of diagnosing anyone), they sure as heck matter to figure out the solution. We’ll be talking more about the various kinds of PF pain in Part 2 of this 5-part series.
In the simplest terms, plantar fasciitis is “inflammation of the plantar fascia.”
Hmmmm…this doesn’t tell us much, does it?
While it doesn’t tell us much…it’s a start. The problem with most ‘diagnostics’ is, they stop here. But not us. We’re going to take this to its end point – or, root cause. We’re going to ask why like an annoying little kid who will not settle for anything less than the truth, until we get to the bottom of this! (Pun intended?! :P)
So, your foot hurts. And there’s inflammation present…
Why is the plantar fascia inflamed?
Ahhhh…by asking this question, now we can get somewhere!
The plantar fascia is inflamed because something (or several somethings) are irritating it. In order to understand plantar fasciitis, we have to understand at least a little about fascia. After all, it’s even in the name of this debilitating issue!
If you want a more comprehensive crash course on fascia, click here.
What is fascia?
Fascia, or connective tissue, coats every nerve ending and then wraps the whole nerve. It wraps every fibril of muscle tissue, every fiber of muscle, every muscle bundle and then every muscle group is wrapped in large tough sheets of the stuff, which come together and turn into tendons and ligaments, also fascia – just a denser version – which connects to our bones. Every bone is coated in a layer of fascia, as are all of our organs.
We have MORE of this fascia stuff than anything else in the body! And this fascial system is meant to be elastic, flexible and able to move with us.
All fascia has within it something called ground substance and the extracellular matrix (ECM), and it is this ground substance that gives fascia its spring because it contains a gel-like substance that keeps the fascia hydrated and our cells nourished.
The ECM is responsible for distributing force and tension throughout the fascial system so we don’t damage ourselves from one hit (it’s our SHOCK ABSORBER!)
BUT – and we’re about to get into what the heck this has to do with plantar fasciitis here in a second – with overuse, under use, age and other factors like trauma and injuries, the fascial system starts to get dehydrated and then brittle. It LOSES ITS SPRING. It also sticks to itself in knots or adhesions, pulling muscle fibers with it and pulling on or irritating attchements.
It is this combo of dehydrated and knotted up restricted fascia that creates pain and inflammation in the plantar fascia.
Why does the fascia become unhealthy?
This is the topic of a future episode. For now, we’re sticking to the anatomical or physiological causes of PF pain.
Most of the time, plantar fasciitis pain is stemming from tightness and restriction in your calves and hamstrings. Sometimes it can come from fascial restrictions higher up the posterior chain or in the upper body like your traps, but those cases are rare in my experience and often indiciate a deeper underlying issue.
The most common pattern that falls into this category is a hip or pelvic instability problem. Going after the glute in this case though wouldn’t be the correct solution, because the glute isn’t the problem either, it’s another symptom of dysfunction! (Part 5 of this series is all about this hip instability issue, and I’ll break it down for you so no need to understand it right now!)
Bottom line is…your plantar fascia starts to get irritated and angry. WHY?
Something (or several things) UPSTREAM are starting PULL on the Achilles tendon and plantar fascia.
At the same time, if your entire lower leg compartment has fascia that is dehydrated and brittle, you’ve lost the ability to absorb and distribute force and tension or in other words you’ve lost your SHOCK ABSORPTION! And…
With EVERY step you take walking around, and especially running, there’s nowhere to distribute the impact – so it’s felt –
And now we have a scenario where all those tiny bones, tendons, ligaments and joints in your foot are bearing the weight and impact of your body and activities, when that job is SUPPOSED to be distributed throughout your entire lower body.
This is one reason why it can start to feel like you’re walking around on a bruise. In many ways this may be quite accurate, because the calcaneus bone and all the small tendons, ligaments and joints within your foot start to feel the brunt of impact from every step and over time may very well start to bruise.
Your body may give you a pain signal here, or it might not happen until the fascia in your foot ALSO loses its spring and if the plantar fascia becomes dehydrated, brittle AND overstretched it is now in danger of tearing. This is one reason people get heel spurs – the body is trying to throw something down to make up for the loss in plantar fascia spring/length/durability.
OR, you may get the pain signal simply due to fascial restrictions in the calves and hamstrings pulling on the Achilles tendon and plantar fascia.
At some point the body, which is extremely intelligent and doesn’t do ANYTHING without reason, isolates that area for healing via INFLAMMATION.
Guess what inflammation does? It puffs up an area and mimics that squishy gel like make up of ground substance!
The body is likely trying to rehydrate that area with fresh plasma and prevent you from using it because that could cause further damage.
Little do you know, because no one ever told you this, but YOU CAN REHYDRATE YOUR FASCIA and give your foot exactly what it needs to stop getting your attention with a horrible and debilitating pain signal.
Most of the time plantar fasciitis is dead simple.
Like – there’s a tack in your forehead? Let’s pull it out! BAM! Done. That simple.
Notice I didn’t say easy, I said simple – the process of getting out of pain involves effort, curiosity and patience, but if it took you years to get here and it only takes a week or two to get out of pain, I’d say that’s pretty great success!
Sometimes however, it can be more complicated. In Part II we’ll be going over the different variations of plantar fasciitis, and why this matters for getting out of pain.