Plantar fasciitis. What it is and how to fix it with 3 easy steps

Pain at the bottom of your feet bringing down the quality of life?

Plantar Fasciitis
If you have pain at the bottom of your feet upon waking up and find it hard (painful) to walk or pain just walking most times that you have to hobble or change your walking gait then you most probably have plantar fasciitis. Plantar Fascia is the largest ligament in the human body! We pay no attention to it as we walk thousands of steps, run around, play sporting activity, jump up and down but yet only when it is painful. By this time you have to see how long the signs have been going on without any form of treatment by a qualified professional or DIY rehab program. Usually when there is pain waking up and you experience this for the very first time it's considered acute and when you have had it before but you just went on with life and then it comes back, that would fall under chronic RSI (repetitive strained injury). It's not that uncommon actually with Plantar fasciitis, it's estimated to affect 1 in 10 people at some point during their lifetime and most commonly affects people between 40–60 years of age but that doesn't mean the younger and active ones don't get it just because they're younger...and active. 

Anatomy of the feet

The plantar fascia is a thick webbing like ligament which help to absorb and transfer force and too much weight or frequent sudden deceleration on your feet can cause inflammation, which the term Plantar(feet) Fasci(connective tissue)itis(inflammation) is referred to when you have been diagnosed with pain at the bottom of your feet. There is not one cause that may cause the inflammation. Below is a non- exhaustive list of what may have caused your plantar fasciitis: 

• Wearing high heels for long duration
• Using the wrong form of footwear 
• Flat foot
• Poor deceleration technique 
• Poor running gait
• Constantly in tight fitting shoes(formal office shoes)
• Being overweight and sedentary
• Under recovery from sports
• Too much weight loading from weight training 
• Past injury that hasn't full healed (scar tissue)
• Kinetic chain compensation / dysfunction

How to fix it (plantar fasciitis)
​Now that we have covered the basics of feet anatomy and what may be the cause of it, let's get to the practical part of fixing it.

Lacrosse ball is used for its firmness, texture and durability

Lacrosse ball seems to be like a go to for most people as the rubbery texture provides more grip than say a tennis ball, the firmness will last forever as well as the density is far more superior, it size is small enough so that you can fit it in almost any bag you carry around be it for travel or the gym. Start of by placing the ball on the floor and work on the level of pressure accordingly from light, moderate and heavy, depending on your pain threshold. More does not equal better in this case, frequency and duration of the application is what you are looking for rather than heavy pressure which causes pain. If anything you want to avoid pain but a mild or slight discomfort is enough.

Before you start, it's important to read this through and use as guidelines: We will use the pain scale of 0-10, 0 being no pain just light pressure, 10 being excruciating pain. You don't want to reach anywhere near six or a seven. A five would normally do the trick for the brain to say to the body that it's in a safe environment and we don't have to  tighten up. So we will use a number eg 4-5, 2-3, 6-7 etc to guide how much pressure to use conceptually. 

Step 1 (mobilising):
NOTE: You can do this seated or standing up, seated making it easiest with light to no pressure and as you stand up, it's much easier to sustain or add gradual pressure

1. Roll the lacrosse ball at the bottom of your feet
2. Find a sore spot and stay for a few moment(start working up to a 6 on the pain scale and then wait till the sore spot becomes a 4 on the pain scale before moving on
3. Find another sore spot and repeat the above
4. Make sure you cover the whole feet after the sore spot has resided by the pain scale 
5. Roll around the whole feet now with movements from the toes, pointing them down towards the floor and upwards towards the ceiling, whilst rolling the lacrosse ball around
6. Spend at least a minimum of 5-10 minutes doing this before moving onto the next step!

Step 2(Stretching): 

Figure 1.0 - Rocking

Figure 1.1 - Toes to wall stretch

Figure 1.3 - Stair/ elevated alternate stretch

Following the progression to stretching the plantar fascia from left to right.

• (Figure 1.0) Rocking is best used to start off as you can control the intensity of the stretch and easily increase the duration without much needed. The final goal is to have your bum resting onto your heels without pain in your knees or hips, and of course the plantar fascia itself. Have yourself move from static stretches to rocking back and forth into a more dynamic move
• (Figure 1.1) Increase the intensity of the stretch by standing up so now it allows light to moderate loading of the body weight onto the plantar fascia. After placing your toes on the wall, move your knees towards and away from the wall, moving your heel off the floor off slowly and with whatever range of motion it allows you reach without pain at the bottom of your feet. Repeat this from 1 to 2 minutes working more on quality of the movement and feel rather than counting repetitions, alternate and work towards a longer duration(example 3-5minutes). When you start counting reps, quality drop! 
• (Figure 1.3) Find a stair you can use or if not a block of yoga mat or even hard case books will do as long as it's stable and enough height for you to do this in full range of motion! Start by standing on the edge with both feet, slowly lower down one leg and stretch it to the fullest end range of motion. Hold that stretch for at least five full seconds and then alternate the heels to go down. Do this for 8-10 repetitions. 

Step 3(Loading/ Strengthening): 
This is it, the last piece of the puzzle! After all that mobilising and stretching, the tissues need to learn how to become stronger with specific demands. There are two main things you need to work on when strengthening the plantar fascia, eccentric loading (slow controlled movement while lengthening under a load) and doing them bare-feet! ​

Figure 2. Everyone is born with the ability to squat like this, not just the asians!

Figrure 2.1 - Suspension trainer help to stabilise and safe enough for those with low mobility

Figure 1.3 - Stair/ elevated alternate stretch

• Following the elevated stair alternate stretch, you start from the top instead and slowly lower your heels till you get to the end range of motion. When you are wanting to start the next repetition, just be on your tippy toes as easily as you can and only work your way down not upwards so you can hang on to something for support. 
• (Figure 2.) Squatting bare-feet engages the whole body which includes the core stability and mobility and suppleness of the whole body as a whole. You don't need a gym for this and you can do it anywhere anytime, just remember to be bare-feet! (Figure 2.1) Use a suspension trainer to help with weight bearing issue and those of us with low stability/ mobility as it helps to stabilise and take off about 30 percent of your bodyweight off which is distributed through the arms and the suspension trainer equipment. If unsure, always seek a professional who can give you sound instruction on using them correctly and  more importantly, safely. 

Well with all that said and done, all the best! Let us know if we missed anything that you think should be in it!