Your mornings are full of the joy of life and without a second thought you bound out of bed ready to take on the whole world, until OUCH!!! you take that first step and a stabbing pain ravages your heel, that’s what millions of sufferers wake up to every day. Becoming an effective Fasciitis Fighter starts with understanding this debilitating condition that strikes without warning.

It’s estimated to be the single most frequently diagnosed cause of heel pain worldwide, paining roughly 2 million American runners every year.

It can crush a high-powered business executive’s productivity, make our college athletes squeal like schoolgirls, and make every step we take agonising.

Knowing how to be a true Fasciitis Fighter is knowing what that ugly thing is, how to make it better, and what actually works.

In this article we explore that all, in a way that is clear and that does you some good.

What is this thing? And how does this happen?

The bane of the runners life; what is now known as plantar fasciitis developed when the plantar fascia, a thick strip of grey-white connective tissue along the bottom of the foot, no longer performed its intended cushioning function. (J Biomech. 2000;33(11):1545-9).

This band connected to the heel bone and the toes acts to disperse impact and stress throughout the foot.

As it becomes increasingly loaded, tiny micro-tears can occur, setting off inflammation and the stabbing pain that characterises the condition so beautifully.

Fasciitis Fighter: Understanding the Root Causes

There are a variety of potential causative factors, which stacked one on top of each other, cause the disorder. Poor gait, characterized by a lowered or excessively high arch, transmits an undue amount of force through our plantar fascia. Having extremely tight calf muscles magnifies this load by hyper-dorsiflexing the ankle with each step. Having an extremely high or flat arch, regardless of other factors, causes an inappropriate distribution of force through the foot, affecting the plantar fascia adversely. Excessive time spent on hard floors- this applies to nurses, teachers, those who work at retail- thins the tissue over time. Suddenly increasing the amount of physical activity undertaken, for instance by increasing our running distance too rapidly, is also well known as a potential cause. Age does play a role, with the highest prevalence seen in myopic 40 and 50-something year olds, though no age is immune. Being in excess weight applies excessive stress to the general biomechanics in much the same way as supporting a table with one leg that’s three times the strength of the other. Owning footwear that is extremely worn out with inadequate arch support is frequently an underestimated contributor toward advancing the disorder, essentially footwear that doesn’t support or cushion the foot well enough primes it to go awry. Recognition of these potential causative factors is the initial step for the serious Fasciitis Fighter to take.

But do you know the actual solutions?

Most people don’t need to have their heels surgically cut open to have this go away, first line treatment is generally conservative. Conservative treatment accounts for approximately 90% of treatment success, but it must be enduring to be effective.

Most people will see notable benefits after three months of diligent effort.

Stretching and Physical Therapy

Stretching is the most evidence supported intervention, and the best is the standard-of-care stretch for the Achilles; pull your heel down to the ground with your toes against the wall, and bend forward toward the wall until you feel a stretch in the back of your leg- so simple! Physical therapy interventions have been shown to be no more effective than stretching for most patients. Equally effective is the plantar fascia stretch, by pulling the toes back toward your shin while sitting down at your desk; perform this multiple times a day and follow it with foot and heel massage to release the tension in the tissue. Consider doing this the first thing in the morning before even taking a step, since overnight it is the tightest, thus most painful. Stretching the tissue 1-2 times a day produces better results than exercising randomly.

Supportive footwear and orthotics

Supportive footwear, with good arch support and heel cushioning minimizes forces directed through the plantar fascia during activity. Over-the-counter orthotics, foam or gel insoles that are commercially available, have been shown to significantly relieve heel pain in most patients. Custom orthotics, made by a podiatrist, fit the individual and often are a need for persistence. Night splints that stretch the plantar fascia during sleep are highly effective, by mantaining the tissue length overnight and preventing that nasty first-step pain the following morning.

Fasciitis Fighter: Long-term Management and Prevention

Signs of relative improvement of pain and recovery from an active phase are not the same as active prevention of future flare-ups. Many individuals enjoy the relief and begin to regress with normal activity soon after. Long-term management requires finding approaches to train, strengthen, and support the biomechanics so that the condition does not reinvent itself. In spite of their boring looking components, a handful of strengthening exercises, such as towel scrunches, shortfoot, and single foot calf raises, perform to build a strong foundation. These take a mere ten minutes a day to perform, and undoubtedly build protection against the disorder. How we train, run, jump, and walk has a significant influence on whether we suffer from sprains, strains, bursitis and the afore-mentioned; in comfortable, healthy, maintainable limits. The less excess weight we gain, regardless of our shape, the less stress is placed through the biomechanics overall. If can even take a few pounds off, we’d be doing more than saving a few dollars buying clothes we have to go out and buy again sooner than we’d like; we’d be protecting our heels.

Modify activity- don’t rest entirely! Complete rest is futile; it causes the tissue to become even stiffer and more uncomfortable on wake-up. Instead, manage the load. If you’re on a high-impact program, consider moving to a low-impact form of exercise until the disorder relents. Be sure to pay close attention to how fast you are increasing your weekly running mileage- and make it slow! Keep the increase under about 10% week-to-week. Lose any excess weight you hold around your body as it more than halves the force to the foot for every pound released. For the worker that is on their feet all day long, if you can incorporate anti-fatigue mats and sitting every once in a while- you will be amazed at the difference it makes. Prevention is much, much easier than any treatment that come after it, so tackle the process early when you still have control in your fasciitis-fighting campaign.

The bottom line is that being a true Fasciitis Fighter involves respecting your body- and there’s no better way to do that than understanding your condition and responding appropriately to it.