Plantar Fasciitis is an inflammation of the plantar fascia which is the tissue underneath the foot that helps maintain the arch.  Pain occurs at the underside of the foot, many times at the heel.  Onset can occur after activities that place stress on the heel and attached tissue, which can include running, dancing and aerobic exercise.  At times however the pain starts slowly without any known cause.

Many times, people try to relieve the pain by treating the plantar fascia using pressure, ice and stretching.  However, in many cases the cause is not at the foot and can relate to the calf muscles, hip and lower back.  An example would be when malalignment occurs at the hip and pelvis.  If the hip becomes elevated and is no longer properly weight bearing this will cause strain throughout the leg to the foot.  Weakness has occurred causing tension in the hamstrings and lower leg muscles.  The tension in the gastrocnemius and soleus muscles which forms the achilles tendon will also create tension in to the plantar fascia as the insertion of the achilles tendon is very close to the origin of the plantar fascia.

Fascia is a thin casing of connective tissue which surrounds and holds every muscle, organ, blood, vessel, bone and nerve fiber in place.  When placed under stress, such as when there is a chronic hip elevation, the fascia throughout the leg will tighten and can lead to plantar fasciitis.  Therefore, evaluation of the pain in the foot needs to look at the balance and alignment of the hips, thighs and legs.  It is likely that the cause of the plantar pain is far from the foot.

Evaluation and treatment need to be focused on the muscular balance of the hips, lower back, and legs.  Once the malalignment is analyzed specific exercises need to be performed to restore muscular balance, strength and alignment to the area.  This will reduce the tension that has built up through the fascial system.  As well, pressure can be applied through a foam roller or ball to hip, thigh, and lower leg muscles that have been chronically under tension.  In my experience treatment will need to be applied to the calf muscles as they have been under stress for a long time.

John Russell RMT