Heel Pain and the Plantar Fascia

Dr. Brooks Newton Articles

Anatomy of the Plantar Fascia

Anatomy of the plantar fascia

Anatomy of the plantar fascia

The plantar fascia is a strong fibrous band of tissue on the bottom side of the foot.  The plantar fascia runs from the calcaneus (heel) and fans out to each of the metatarsal heads (base of each toe). 

This fibrous tissue plays a critical role in establishing the longitudinal arch of a person’s foot.  The arch of one’s foot allows us to absorb and transmit the forces more efficiently than a flat surface – similar to that of a spring.

Pathology

Classically, injuries to the plantar fascia will manifest as intense heel pain that is worse with the first step out of bed in the morning.  That heel pain is due to micro-tearing and subsequent inflammation or degeneration of the plantar fascia.  There are a multitude of reasons why one’s plantar fascia would develop tears, but we can think of them all in two broad categories: 

Increased tension through the plantar fascia

Dysfunction within the secondary structures associated with establishing the arch

Tension

Increased tension through the plantar fascia is caused when a person has either tissue length inequalities or sliding surface dysfunction in the posterior chain of the lower extremity.  Tissue length inequalities represent shortened soft tissues.  Every tissue has a proper physiological length as well as sliding surface function.  Sliding surface function represents that ability of our tissues to slide and glide across each other.  When adhesions develop within or between our tissues, it limits the contractibility, slide, and glide of our soft tissues. 

Dysfunction

As stated before, the plantar fascia plays a role in establishing the arch of the foot.  Another group of structures that are responsible for establishing that arch are the intrinsic muscles of the foot.  The plantar fascia and the intrinsic muscles have a symbiotic relationship.  They work together to accomplish a task – maintaining the arch.  When one does not do its duty, the other must pick up the slack.  Commonly, the intrinsic muscles become under-facilitated and dysfunctional. 

Addressing Inadequacies and Dysfunction

Tension

1. Hip Mob

Foam Roller Hip Smash

Foam Roller Hip Mobilization

Foam Roller Hip Smash

Foam Roller Hip Mobilzation

2. Hamstring Mob

Doorway

Hamstring Mobilization

3. Calf Mob

Calf Mobilization with Softball

Calf Mobilization with Softball

Dysfunction

4. Four-Toe Salute

Four Toe Salute

Four-Toe Salute

5. Big-Toe Salute

Big-Toe Salute

Big-Toe Salute

6. Toe Splay

Toe Splay

Toe Splay

About the author

Dr. Brooks Newton
Dr. Brooks Newton

Dr. Brooks Newton is a licensed Doctor of Chiropractic as well as a Certified Strength and Conditioning Specialist, a CrossFit Level 1 Trainer, and a CrossFit Mobility Trainer. He specializes in the treatment of orthopedic and sport injuries which has lead him to work with athletes from the ranging from the NFL, NHL, Crossfit Games, NCAA Div I, II, and III, and the Chinese Olympic Teams.

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