Plantar Fasciitis and Heel Pain, Pelvic Instability and Glute Inhibition – Acute Cause vs Root Cause

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Plantar fasciitis can be debilitating. Whether the pain you’re feeling is in your arch or your heel, feels like a sharp stabbing knife or a hot poker lodged in your foot, if you’ve ever felt this pain you know how painful it is just to put the weight of your leg on the ground. 

But what exactly causes plantar fasciitis?

Western medicine tells us the plantar fascia is inflamed, and the choices of treatment range from rest and rolling your foot on ice, to cortisone injections, boots and braces all the way to surgically separating the fascia on the bottom of your foot. 

Typically, the medical model isolates the foot for diagnosis and treatment, without considering that the human foot is part of the whole human body and organism. 

Why is the plantar fascia inflamed (aka, irritated/lacking nutrients/injured)?

In order to solve this mystery, we have to look at the rest of the body. In my private practice, we “map” the entire lower body to figure out what is causing the pain and what relieves it the quickest. 

What I discovered long ago is that most people with plantar fasciitis get immediate relief by releasing the fascia in their calves and hamstrings. 

Calf fascia release typically eases or eliminates pain in the arch, while releasing the hamstring fascia works wonders for heel pain. 

If you look at fascia lines in the body, this makes sense. There’s a thick sheath of fascia that runs through the back body (hamstrings) and connects to the heel, whereas the calves can contain fascia medially and laterally (inside and outside) that can lead to pain in the arch (and occasionally, pain in the outside part of the foot or heel). 

While these two areas can bring immense relief (often instantly), the pain often comes back. In order to find the root cause, we have to dig even deeper. 

Why is the calf or hamstring fascia so tight? This is an especially important question to ask if you have plantar fasciitis or heel pain in only ONE foot (left or right). Most people with PF tend to experience it on only one side, or one side first and eventually on both sides. 

To answer this question, we have to look even further upstream: to the hips, pelvis and glutes. 

The human body is amazing at compensating. When one area of the body is compromised structurally, another area takes over. This can go on for years or decades, before you get a pain signal. Most people get a pain signal when their body can’t compensate any longer. 

The human brain will prioritize spinal stability over just about everything else, because your spinal cord lives there. Your spinal cord makes up your central nervous system, and is the means by which your brain can talk to your body (to keep your heart beating, your lungs breathing, aka – to keep you alive). 

If your brain detects that your spine is unstable for any reason, there will be an immediate compensation. 

Often, the calf and hamstring fascia are overworking to compensate for a lack of pelvic or hip stability. This is especially true for anyone that works on their feet, or works out on their feet: runners, hikers, CrossFit athletes, yogis….most of what we do as humans for movement involves being on our feet. 

The pelvis or hips become unstable due to imbalances left to right in the leg fascia, specifically the thigh muscles (and their fascia): quads, quad hip flexors, IT Bands and adductors. This BIG muscles contain big sheaths of fascia that can get dehydrated, stick together in knots and destabilize the pelvis. 

Then, the brain kicks in and tells your gluteus medius (for example) to contract to keep the hip and pelvis stable. When this happens, your gluteus medius is no longer available to fire on command during exercises like squats, deadlifts, marathons and yoga sequences where you’re on your feet or hands and feet. 

Your foot (on the side where the glute is neurologically contracted) starts to grip the ground to stabilize your hip, which tightens up your foot and calf fascia…and can eventually lead to plantar fasciitis. 

Or, your hamstrings kick in to work overtime to stabilize you through certain activities since you no longer have glute activation, eventually tightening up so much it irritates the heel…leading to that pain signal you’re feeling. 

So…the BIG question is: what causes pelvic instability? The short answer is something I already shared above: imbalances left to right that destabilize the spine. 

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