The Center for Podiatric Care and Sports Medicine

Whole Body Approach: New Thoughts about Treating Plantar Fasciitis

Posted by on Monday, March 31st, 2014

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One of the benefits of working with a sports medicine center, versus a regular podiatrist or physician’s office, is that we look beyond the feet and into total body biomechanics. We understand that the pain you feel in your heels could lead to pain in your back if left untreated. We also understand that weakness in your leg muscles can contribute to the pain in your feet. Rather than jump to extreme measures or medication, we are sure to examine conservative measures that can make a world of difference in a difficult-to-treat condition such as plantar fasciitis.

 Diagnosing Plantar Fasciitis

Plantar fasciitis affects some 1 million Americans each year. Diagnosis is usually made with a physical examination. Symptoms of plantar fasciitis include:

– Heel pain, especially in the morning or after prolonged periods of sitting

– Sharp pain in the medial plantar calcaneal region

plantar fasciitis pain
Pain in the medial plantar region may indicate plantar fasciitis, inflammation in the ligament running from your heel to the ball of your feet.
Image Source: Docpods.com

– Pain during the push-off phase of running, rather than the contact phase

– Increased discomfort when shifting weight onto the toes

What Causes Plantar Fasciitis?

There are many theories as to what causes plantar fasciitis, but a new school of thought posits that tight calf muscles and weakness elsewhere in the body leads the feet to overcompensate and accept too much force. Flattened arches and weak calf muscles are common in heel pain sufferers, for example.

Other research has found a connection between the plantar fascia and the Flexor Digitorum Brevis muscle (FDB), which helps share the load. “Runners routinely expose the plantar fascia to up to seven times their body weight during the push-off phase,” writes Tom Michaud for the running magazine Competitor.

He adds, “The FDB muscle tenses to distribute pressure away from the overworked plantar fascia… the best predictor of the development of plantar fasciitis is not the height of the arch, but the speed in which the toes move upward during the propulsive period (which occurs when the FDB is weak).”

Therefore, treatment of plantar fasciitis should involve strengthening the Flexor Digitorum Brevis muscle.

FDB muscle
Strengthening your FDB muscle can alleviate stress placed on the plantar fascia.
Image Source: FootDoc.ca

Does Your FDB Muscle Need Strengthening?

There are two ways to tell if your FDB muscle is up to par or not:

1. Look at your running shoe insoles. Are there clear indentations beneath the toes? If so, then your FDB muscle is probably strong.

2. Sit in a chair with your hips, knees and ankles at a 90° angle. Have a friend place a business card beneath the little toes. Try to stop the card from being pulled away by pushing down with the tips of your toes. If your friend has trouble pulling the card away, then your FDB muscle is strong.

Strengthening Exercises for Plantar Fasciitis

1. Stretch the fascia by putting your toes up against a wall, keeping your arch and heel flat and holding for 10 seconds. Repeat this three or four times throughout the day.

2. After stretching for 10 minutes, roll a frozen water bottle under your arch.

3. Roll a golf or tennis ball along the underside of your foot, putting good pressure on the back, center, and front of the foot for 15 seconds before moving to the next region.

4. Practice picking up marbles with your toes.

5. Pull your big toe back for a deep 10-second stretch.

6. To stretch your calves, lean against a wall with the back knee straight and the front knee bent. Place the back heel flat on the ground and push your hips toward the wall, holding for 10 seconds and repeating 20 times per foot.

7. Use a foam roller on the rest of your body.

Get Professional Help from NY Sport Doctors

If you live in the NY area, we’d be happy to work with you in alleviating your plantar pain once and for all. In addition to creating a custom stretching program for you that you can do on your own or with one of our physical therapists, we also make custom orthotic insert casts and offer the latest technology in plantar fasciitis treatment, including extracorporeal shock wave therapy. Remember, pain is NOT normal and you do NOT have to live like this! Make an appointment at The Center for Podiatric Care and Sports Medicine today.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.