The function of the heel in walking is to absorb the shock of your foot striking the ground as it is put down and to start springing you forward on the next step. Under the foot are a many small pockets of fat in strong elastic linings, which absorb much of the shock (fat pads). The heel is attached to the front of the foot by a number of strong structures which run between the front part of the heel bone and other parts of the foot. The strongest is the plantar fascia, which attaches the heel to the toes and helps to balance the various parts of the foot as you walk.
What’s going on under the skin – note the separate lateral band which is often neglected in lengthening & stretching.
The plantar fascia can be viewed as a series of bow strings which support the foot arch and forms a “trampoline” like series of springs.
Where the plantar fascia becomes inflamed, the condition is called plantar fasciitis (“itis = any form of inflammation).
Not all foot pain is plantar fasciitis – there is a very strong fascial continuity between the plantar fascia and all the tendons & muscles that plantar flex (bend) the foot & toes. Common causes include:
- overuse, such long distance runners, people who have to stand all day or are very overweight
- stiffness of the ankle or tightness of the Achilles tendon / muscles of the lower leg – people with plantar fasciitis often have a tight Achilles tendon and vice versa, those with tight calf muscles may find they develop plantar fasciitis
- walking barefoot on hard surfaces, wearing flip-flops, backless shoes or high heels
- people who have high-arched or flat feet are less able to absorb the stress of walking and are at risk of plantar fasciitis
- a rheumatic condition such as rheumatoid arthritis or ankylosing spondylitis may produce inflammation anywhere a ligament is attached to bone (enthesopathy) and plantar fasciitis is part of the general condition
Usually plantar fasciitis gets better by itself, but this can take months or even years – it is a notoriously difficult injury to get rid of and prevention is much better than cure.
In my experience it is very usual to treat cases of this after the summer holidays, when clients have spent more time than usual barefoot or in flip-flops. They resume their exercise routine with vigour but with tight calves, achillies and plantar fascia. A few weeks later – ouch!
Jane’s tips for an injury-free September
Heel & foot pain is much more commonly seen in females aged over 40, so if that’s you (and even if it isn’t), then read on …
- minimise the shock to your feet – if you have hard floors at home then wear soft trainers most of the time
- sight-seeing and days out, ditch the flip flops and choose the trainers or at least footwear with a heel-strap – this is especially important if you have very high-arched or flat feet and / or hallux valgus (bunions!)
- if you have flattish feet then a moulded insole or gel heel-raiser in your shoe may reduce the stress on your feet
- after a day on your feet, do the straight knee / bent knee lower leg stretches that we do in Metafit
- roll a tennis ball along the soles of your feet, slowly and thoroughly, covering the entire foot from the ball of all 5 toes TOWARDS the heel and do not neglect the lateral band
Strengthen the plantar flexors with the single-leg heel raise as shown here.
Try 8-10 each leg
If you find yourself actually in pain then do talk to me. The appropriate soft tissue work and rehabilitative exercises done in time can prevent this developing into an insidious injury that is tough to shift.
A forward bend with straight knees will challenge the entire posterior chain. Try tennis ball rolling your right foot and notice how the right arm hangs lower. What goes on at the feet goes on in the hamstrings, glutes and spine.
Soft Tissue & Remedial Massage Therapist
LSSM (dip) BTEC 5 (dip) MISRM, CNHC