Spotlight: Plantar Fasciitis & the Benefits of Massage
What is plantar fasciitis?
Plantar fasciitis is an inflammation of the thick band of connective tissue (plantar fascia) that connects your heel bone to the base of your toes. The primary symptoms of plantar fasciitis are swelling and pain in the heel, especially in the first steps you take in the morning after getting up.
This painful condition is very common and in most cases is treatable without surgery. Some non-surgical interventions include the use of orthotics, night splints, corticosteroid injections, changes in activity, physical therapy, icing, and a combination of focused massage and stretching of the foot and lower leg.
This last intervention is what we’ll be diving into here! Focused massage by a trained professional and stretching the arch, toes, and calf muscles have been shown to be effective for relieving pain and improving range of motion.
Plantar fascia - Its role and function in the foot
The plantar fascia runs along the arch of your foot, and helps to support the arch and maintain structural integrity of the foot. The springy nature of this band of tissue is essential for stability and dynamic movements such as running, walking, ballet, and sports of all kinds. In some people, this band is naturally shorter/tighter (high arches), while in others it is longer/looser (flat feet). The tightness of the plantar fascia can also change over time depending on activity level and other lifestyle factors.
This band of tissue lengthens (stretches) during certain movements involved in walking, running, and nearly any activity in which you are on your feet. Over time, this repeated lengthening can damage the tissue, especially if you are engaged in high-impact exercise or long periods of standing. Chronic irritation in the foot’s arch due to excessive strain is the primary cause of plantar fasciitis and its painful symptoms.
What can be done to treat plantar fasciitis?
Alleviation of the pain of plantar fasciitis is not the only reason to treat this condition promptly. Often the pain and discomfort will prevent a person from engaging in physical activities, or at least to decrease their activity, which will itself have negative health consequences. Because regular exercise is an essential component of cardiovascular, musculoskeletal, metabolic, and mental health, it is that much more important to relieve the irritation and strain of plantar fascia!
As mentioned earlier, there are many treatments for plantar fascia that do not involve surgery. Most evidence suggests that a combination of treatments is the most efficacious approach, and which treatments are best will depend on the individual, their activity levels, and other factors.
A massage therapist can use a variety of techniques to help reduce strain on the plantar fascia to alleviate pain and increase range of motion. Direct massage on the band of fascia (always gently and slowly), myofascial release of the arch of the foot, and stretching of the muscles of the calf have all been shown to be effective in relieving plantar fasciitis pain.
While there are stretches you can also do at home (see below), it can be helpful to have a trained and knowledgeable Massage Therapist or Physical Therapist assist in relieving tension and strain on the plantar fascia. Because we are trained and experienced in assessing muscle and connective tissue, we can apply appropriate stretch and pressure, as well as specific techniques, in a way that is powerful but not damaging.
Research has shown that these techniques can help to:
Reduce pain intensity
Improve functional ability
Reduce tenderness
Even if you are seeing a Massage Therapist and/or using interventions as directed by your doctor, there are also stretches and techniques that can be very helpful to do at home! Keep in mind that stretching should always be done slowly and without pain. Aggressive or fast stretching can further damage tissues and worsen the strain that you are trying to relieve.
Here are few things you can do at home to help alleviate pain from plantar fascia:
Stretching the calf muscles:
“... calf muscles (gastrocnemius and soleus) need to be flexible. This is achieved by slowly leaning forward while facing a wall, with the knee straight and the heel on the ground until you feel a pull in the back of your upper calf. After holding this stretch for 30-60 seconds, allow your knee to bend, and feel the stretch in your lower calf. This should be repeated 3-5 times per day.” – American Academy of Podiatric Sports Medicine
Stretching the arch of the foot:
Kneeling on the floor, tuck your toes under and slowly bring your hips toward your heels, supporting yourself with hands on the floor if needed. Go until you feel a stretch across the sole of your foot, and hold this for 30-60 seconds, making sure to breathe through the stretch. Release this and untuck your toes, bending and flexing them to release any soreness or stiffness. Repeat once or twice.
If the above stretch is too intense, you can stretch the arch of your foot and toes by using your hands. Sitting on the ground with legs out in front of you, place your palm over your toes and pull toward you, bending your knees as much as you need to in order to comfortably reach your toes. Pull until you feel a stretch through the arch of your foot, and hold for 30-60 seconds.
Using a tennis or lacrosse ball to massage arch of foot
As with stretching, make sure that you are doing this slowly and carefully, without causing pain. Use a ball to massage the arch of your foot and into the ball of your foot as well, for 2-5 minutes per foot.
Because the heel itself can be very tender with plantar fasciitis, avoid rolling the ball directly on the heel itself. Instead, keep to the band of tissue running between the heel and the base of the toes, longitudinally along the arch.
If you have been diagnosed with plantar fasciitis and want to explore the benefits of treatment from a Licensed Massage Therapist, I invite you to take a look at my Services and book a massage today!
Always consult your Primary Care Physician or trusted health advisor if you have any questions or concerns, and to receive diagnosis of this or any other condition. It is important to receive an accurate diagnosis so that you can make sure you are seeking appropriate treatment. The above information is provided for educational purposes and is not a replacement for the advice of a medical professional. The above should not be considered grounds for diagnosis or a prescription of treatment.
Works Cited
Ajimsha, M.S., et al. “Effectiveness of Myofascial Release in the Management of Plantar Heel Pain: A Randomized Controlled Trial.” The Foot, vol. 24, no. 2, June 2014, pp. 66–71, www.sciencedirect.com/science/article/abs/pii/S0958259214000133, https://doi.org/10.1016/j.foot.2014.03.005.
Baburao Jadhav, Aditi, and Peeyoosha Gurudut. “Comparative Effectiveness of Gua Sha, Cryostretch, and Positional Release Technique on Tenderness and Function in Subjects with Plantar Fasciitis: A Randomized Clinical Trial.” International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice, vol. 16, no. 1, 2 Mar. 2023, pp. 13–23, https://doi.org/10.3822/ijtmb.v16i1.749.
Kim, Wangdo, and Arkady S. Voloshin. “Role of Plantar Fascia in the Load Bearing Capacity of the Human Foot.” Journal of Biomechanics, vol. 28, no. 9, Sept. 1995, pp. 1025–1033, https://doi.org/10.1016/0021-9290(94)00163-x.
Mayo Clinic. “Plantar Fasciitis - Symptoms and Causes.” Mayo Clinic, 2018, www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846.
Olson, William R. “Plantar Fascitis: A Detailed Look – What Is It, Treating It.” Www.aapsm.org, American Academy of Podiatric Sports Medicine, www.aapsm.org/plantar-fasciitis.html.
Orchard, J. “Plantar Fasciitis.” BMJ, vol. 345, no. oct10 1, 10 Oct. 2012, pp. e6603–e6603, https://doi.org/10.1136/bmj.e6603.
staff, familydoctor org editorial. “Plantar Fasciitis - Symptoms and Treatment.” Familydoctor.org, 1 June 2023, familydoctor.org/condition/plantar-fasciitis/?adfree=true. Accessed 8 Nov. 2023.
Yelverton, Christopher, et al. “Manual Therapy Interventions in the Treatment of Plantar Fasciitis: A Comparison of Three Approaches.” Health SA Gesondheid, vol. 24, 25 Sept. 2019, https://doi.org/10.4102/hsag.v24i0.1244.