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Plantar fasciitis - an overview

Here in Vermont, it is truly starting to feel like spring. Buds are appearing on the trees, the first hints of green are peeking out of the garden soil, and birds are winging their way northward in anticipation of summer. For many of us, springtime brings a shift in outdoor activities as we swap out snowshoes for running shoes and hiking boots, and gear up for biking as the skis are put away for the season. These opportunities for fun and adventure can sometimes lead to injury and pain, which can limit enjoyment in the outdoors and even make basic tasks difficult or impossible.

One of the most common complaints that prompts clients to schedule a reflexology session is plantar fasciitis. In this three-part blog series, let’s take a look at what plantar fasciitis is, common causes, and options for prevention and getting back on your feet when dealing with plantar fasciitis.

First things first- to understand plantar fasciitis, we need to start with fascia. Fascia is a connective tissue that covers muscles and organs throughout the body, providing protection and support. Connective tissue health has also been shown to be connected to how our bodies respond to, and heal from injury. Locally, at UVM Medical Center, researchers at the Langevin Lab are leading the way in investigating how changes in connective tissue through stretching and acupuncture impact inflammation and pain sensitivity.

The plantar fascia refers specifically to the fascia on the bottom of the foot. However, the fascia is interconnected throughout many parts of the body. This understanding of interconnectedness provides one of the theories for why reflexology on the feet lessens pain symptoms in other parts of the body. This video shows the continuous line of fascia from the toes, up the backs of the legs, the back, the back of the head, and up over the top of head to where it connects just above the eyes. (Be forewarned, the video does show the actual fascia from a cadaver, but if you are not squeamish, it is well worth the 2:00 minutes it takes to trace the path from feet to head.)

Plantar fasciitis is a very common cause of foot pain, affecting an estimated 10% of the adult population and accounting for approximately 600,000 outpatient medical visits each year in the United States (Cole et al, 2005). While the term “fasciitis” refers specifically to an inflammatory condition, researchers have hypothesized (based on viewing samples of fascia under microscopes) that the pain is caused in part due to the tissue actually breaking down, rather than a classic inflammatory response (Lemont et al, 2003). This concept will become important when we examine some of the common causes of plantar fasciitis.

Plantar fasciitis symptoms include stabbing, throbbing, or searing pain on the plantar aspect (bottom) of the foot, often just beneath the heel. It is common for the pain to be at its worst in the morning, after long periods of standing, or standing after a period of sitting. Many people also describe the pain as being worse after exercise, rather than during exercise (Mayo Clinic, 2018).

A direct cause of plantar fasciitis is unknown, however, there are several factors that can increase your risk. Fortunately, understanding many of these factors can help you keep your feet strong and healthy to decrease the risk of foot pain and injury. The next blogs will explore causes, prevention and recovery in greater detail.

Works Cited:

Cole, Charles et al. “Plantar Fasciitis: Evidence-Based Review of Diagnosis and Therapy.” American Family Physician, vol. 72, no. 11, 2005, pp. 2237-2242,
https://www.ncbi.nlm.nih/gov/pubmed/16342847. Accessed 10 Oct. 2018.
Lemont, Harvey et al. “Plantar Fasciitis: A Degenerative Process (Fasciosis) Without Inflammation.” Journal of the American Podiatric Medical Association, vol. 93, no. 3,
2003, pp. 234-237, Accessed 10 Oct. 2018.
“Plantar fasciitis.” Mayo Clinic, 14 April, 2019, fasciitis/symptoms-causes/syc-20354846.

Melanie Giangreco