The Plantar Fascia – What Is It?
The plantar fascia is an important part of the foot that provides power, stabilization, and movement. It spans the length of the foot from the bottom of the heel to the base of the toes, and if a problem develops with this sheet of collagen, it becomes very difficult to walk effectively. Inflammation of this ligament causes the common ailment plantar fasciitis. It can cause difficulty walking and standing for long periods of time, and it is often challenging to treat to satisfaction. Because it bears weight and is responsible for the movement of the foot, any inflammation can cause excruciating pain.
What is the Plantar Fascia?
The plantar fascia is a thick, flat bundle of connective tissue that runs the entire length of your foot. The ligament is actually a continuation of the Achilles tendon that comes down the back of your leg from your calf muscle into the heel. Your plantar fascia proper starts at the bottom of the calcaneus, or heel bone. It spans the entire arch of the foot to the near edges of the phalanges, or bones that comprise the toes. The longitudinal fibers of collective tissue, or collagen, separate into three distinct branches as they get closer to the toes: the medial portion, the central portion, and the lateral portion.As you grow older, your Achilles and plantar fascia begin to lose contact with one another, so that they have no fibers connecting them in older adults. Although the two structures are connected, distinct demarcation lines are noticeable, making the Achilles a separate entity from the plantar fascia. Exercises intended to stretch the Achilles and the calf muscles still can provide relief to the plantar fascia because of this close connection between the two structures.
What Does the Plantar Fascia Do?
The plantar fascia supports and controls the arch of the foot. It acts as a bridge between the front and back of the foot and takes the weight of the body through all phases of the gait cycle. The plantar fascia is estimated to handle 14 percent of the work of the foot. When researchers tested the strength of this ligament, they found that it fails at very high loads, and it usually fails at the point where it intersects with the calcaneus. This is where most people report foot pain when they have a problem with their plantar fascia.The ligament is very active during all phases of the gait. On contact with the ground, the plantar fascia elongates and takes the weight of the foot where it comes down on the arch. When you walk through your foot and push off, the plantar fascia acts like a spring or windlass to bring your foot back into the natural shape of your arch. It is this elastic movement of the plantar fascia that can sometimes cause pain. When it is stretched and springs back during the walk cycle, it aggravates any injuries that may be present along its length. Since it is impossible to walk without activating this spring mechanism, any injury to the ligament can cause intense pain.
Problems with the Plantar Fascia
The most common type of problem that occurs with the plantar fascia is plantar fasciitis. This is inflammation of the long, smooth connective fibers. From overuse or undue strain, the plantar fascia develops tiny tears along its length. These tears are like a beacon in the body, and they call all the injury repairing chemicals that your body produces. This includes white blood cells, cytokines, and other inflammatory response mechanisms. Since the plantar fascia is such a small area, the accumulation of these chemicals makes the area swell up and cause pain.This swelling will often present as redness and tenderness at the heel or along the arch. The most common reasons for plantar fasciitis include obesity, long distance running, and flat feet. In all these cases, the foot must take on more strain than normal. With obesity, the weight puts undue pressure on the arch and stretches the plantar fascia more than necessary. Long distance running causes repetitive stress injury of the plantar fascia. In this case, the constant pounding causes the injuries to the ligament. With flat feet, the foot over pronates, or rolls inward towards the other foot, and this strains the plantar fascia.
How to Help Your Plantar Fascia
The best way to help your plantar fascia is to lose weight, rest your feet, and wear supportive shoes. It is sometimes hard to implement these changes when you already have the problem with your feet. Exercises that stretch the arch of your foot and the Achilles tendon are often useful for relieving pain. Many different strength and flexibility exercises are available to help you relieve the pain in your foot.Ice can sometimes help with the pain because it helps to decrease swelling and inflammation. Similarly, medications such as non-steroidal anti-inflammatory drugs (NSAIDs) can help cut down on the amount of chemical responders that are rushing to the injured plantar fascia. In more extreme situations, medications such as steroids are used to help relieve the pain. In fact, your doctor can directly inject the steroid into the plantar fascia to reduce the swelling.
The most common treatment for plantar fascia issues is orthopedic shoes and inserts. You want to find shoes that support your arch, especially if you have flat feet, and keep your foot from rolling inward, or over-pronating. Many shoes, such as special tennis shoes, are specifically made to help people with plantar fasciitis, but you can also get inserts to put in any shoe to make your feet feel better. Some of these inserts are available in drug stores, but for more severe cases, you can have a custom insert created by a specialist that will help your specific foot problems. It is worth looking into if you have a constant, painful problem with plantar fasciitis.
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