Put one foot in front of the other
Walking is a pursuit in which many people participate to improve their fitness or to battle weight gain. Aided by step counters such as Fitbits or Apple Watches, we tally our daily stride to reach the elusive goal of 10,000 steps. However, some people are severely hampered by walking because of painful feet. A common condition known as plantar fasciitis is often the culprit, and is characterized by severe tenderness in the arch or heel of the foot. Plantar fasciitis is an injury that many people are unaware of until they experience it firsthand. Afterwards, they discover that many others suffer from this complaint, too. The good news is that plantar fasciitis is both treatable and preventable.
Fascinated by fascia
To appreciate the causes of plantar fasciitis, it is helpful to understand parts of the foot which can be prone to injury. To begin, each foot is home to 26 bones, 30 joints and more than 100 muscles, tendons, and ligaments. These work together to provide support, balance, and mobility.
Fascia is the thick connective tissue which reinforces and shapes soft tissue, such as muscles. It represents one of the most extensive networks of the human body.
Plantar refers to the sole of your foot. Thus, plantar fascia is a band of tissue that spans the bottom of your foot and connects the heel bone to your toes. Plantar fascia is particularly important because it maintains the shape of the arch on the foot’s underside. Your arch serves an important role in shock absorption (and propulsion) during walking, running, and jumping.
Fascia on the underside of the foot becomes inflamed due to overstretching or overuse. As noted previously, pain is typically sensed in the arch or heel.
Often, the onset of plantar fasciitis arises from modifications to your daily routine. For example, altering your footwear or starting a new activity or sport may place abnormal strain on the fascia of the foot. Furthermore, plantar fasciitis tends to be more common with ageing as the muscles supporting the arch of the foot become weaker, placing stress on the plantar fascia.
Specific causes include the following:
- Requiring feet to absorb too much body weight
- Using footwear that offers minimal arch support (flip-flops)
- Loading the foot too quickly by participating in sports or activities that place stress on the heel bone (impact volume)
- Increasing walking or running duration too quickly
- Pronating the foot while walking or running (placing greater weight on the inside edge of the foot)
- Growing older so the muscle becomes weaker
Again, plantar fasciitis is treatable and preventable
A vicious cycle
Plantar fasciitis typically takes a while to heal. Once the fascia swells, the tissue becomes very sensitive to overload from weight bearing. Even minimal impact or ‘light’ activities cause this condition to worsen. Moreover, fascial tissue tightens during overnight rest. You may sense pain when you arise from bed, and then experience less pain throughout the day as the fascia stretches. The discomfort typically returns at the end of the day, due to increased inflammation.
Treatment for plantar fasciitis is a balancing act – a fine line between doing too much, but enough to keep progressing.
How to stand on your own two feet
Here are a few guidelines that will help prevent the onset of plantar fasciitis:
- Keep your feet, ankles, and calves strong
- Maintain a healthy weight
- Ensure you have well-fitting shoes, with suitable arch support. Shoes should be less than 12 months old if you use them regularly
- Request an assessment from a physiotherapist (physical therapist) to determine if you tend to pronate your feet while walking
If you wish to start an exercise program – even a walking program — start gradually. This is different for everyone, but the general rule is to make your first few sessions about 70-80% of your maximum capacity. Have a day of rest between days of increased activity and use the 10% rule (increase load or volume by no more than 10% each week).
Try these 3 exercises to keep your fascia supple and your calves strong:
1. CALF STRETCH
- Stand an arm’s length from a wall.
- Place your right foot behind your left.
- Slowly and gently bend your left leg forward.
- Keep your right knee straight and your right heel on the ground.
- Hold the stretch for 20 to 30 seconds.
- Repeat on the other side.
2. PLANTAR FASCIA STRETCH
- Stand up straight facing a wall.
- Place the toes of your affected leg on the wall.
- Keep your heel on the floor.
- Keep your knee straight and bring your hips towards the wall.
- You should feel a stretch down the back of your calf.
- Hold this position for 20- 30 seconds.
3. HEEL RAISES
- Start in a standing position with your feet at hips-width apart.
- Keeping your knees straight, lift both heels and rise on to your toes.
- Return to the starting position, controlling the movement as you lower your heels to the ground.
For more information about walking as a form of exercise, see these blogs:
Walking to Health and Fitness and Trekking –Putting Your Best Foot Forward