Plantar fasciitis has been the topic of several blog entries on our site. This is because it is common, it can be stubborn and lots of patients ask us about it. Thanks to some interesting new literature, our understanding of this condition is improving and we’re better able to help our patients with plantar fasciitis.
To review from previous blogs, plantar fasciitis is characterized by pain in the bottom of the foot. Usually a bit more on the inner / front part of the heel (calcaneus), the pain with plantar fasciitis is often worst first thing in the morning getting out of bed. It will slightly improve after some walking, eventually getting sorer with walking or standing throughout the day. The bottom of the foot is usually painful with pressure and more pain is experienced when a stretch is put on the bottom of the foot.
The posterior chain is a slang term used by practitioners to describe the various structures on the back of the leg; the hamstrings, calf muscles and the plantar fascia. A fairly recent, interesting study shed some light on posterior chain tightness and its relation to plantar fasciitis. The investigators looked at fifty subjects with plantar fasciitis and measured how “tight” their posterior chain was. They compared this to control subjects. Generally speaking, the findings suggested that posterior chain musculature may be tighter in those people with plantar fasciitis. So what does this mean?
When treating plantar fasciitis, it is important to examine the entire posterior chain for relative tightness. If present, it might be appropriate to direct soft tissue treatments to these areas. For example, at Burlington Sports Therapy we often utilize treatments like active release, graston technique, soft tissue therapy and massage therapy to areas of tight, overused muscles. These treatments might be directed at the hamstrings and calves of those affected by plantar fasciitis. Additionally, it might be recommended that those patients stretch these areas at home. Foam rolling and the use of a “stick” over these areas might also be helpful. Again, an example where the latest evidence assists our clinical decision making…
Curious about the aforementioned treatment approaches for plantar fasciitis? Click here.
Bolivar YA, Munuera PV, Padillo JP. Relationship between tightness of the posterior muscles of the lower limb and plantar fasciitis. Foot & Ankle International 2013; 34(1):42-48.