Plantar Fasciitis and remedial massage

Plantar Fasciitis can be an intimidating term to come across if one is unfamiliar with medical language. The most simple explanation is that it is referring to a sore foot, however a deeper understanding can be gained by breaking down the meanings behind the words.

Working backwards, the suffix “itis” means inflammation; Bronchitis is an inflammation of the bronchial tubes. Therefore, Plantar fasciitis is an inflammation of the plantar fascia

The word ‘Plantar’ is referring to the plantar surface of the foot, as in the part that ‘plants’ on the ground, the bottom. Fascia, put simply, is the connective tissue, it is made up of sheets, which attach, stabilise, enclose organs and separate muscles. Our understanding of the fascia is consistently expanding, with the medical community recently broadening the definition to include all collagenous soft tissue as well as some tendons, ligaments and bursae.

When discussing plantar fasciitis some sources refer to plantar fascia as a band of tissue or a ligament lying beneath the skin of the foot, connecting the heel to the front of the foot, supporting the arch. However, in my opinion, it is important to understand that the plantar fascia as part of a greater fascial network. I believe this distinction is important as the source of inflammation is often a restriction of the lower leg muscles. Imagine the fascia as a sheet stretching from the toes to the knee, if that sheet is being pulled from the knee, it is going to affect the other end of sheet, on the sole of the foot.

Plantar fasciitis usually presents as pain on the bottom of the foot near the heel. The pain most often arises after a period of inactivity, such as the first few steps in the morning, or after a long car ride. The symptoms can be felt the most after, but not during, exercise or activity.

Plantar fasciitis has many varying causes; the plantar fascia is responsible for supporting and stabilising the foot through daily activity. Repetitive high loads can cause fatigue and inflammation is the body’s way of expressing this. In most cases, the cause is a combination of factors such as; a change from supportive footwear to slippers or thongs, weight gain or sedentary lifestyle placing pressure on the tissue, work that requires prolonged periods of standing, abnormal walking or running patterns placing extra pressure on the sole of the foot, a loss of collagen and elasticity which is unfortunately a side-effect of advancing in age.

Plantar fasciitis treatment focuses on relieving the pressure that is affecting the tissue, addressing the fatigue and lengthening the muscles causing the fascia to become inflamed. In some cases, simply stretching the muscles can be effective. However, in a good deal of cases, outside assistance is necessary.

As a massage therapist I like to approach the issue from a couple of angles, firstly a myofascial release of the plantar surface of the foot, encouraging an unwinding of the tissue by gently sinking into the fascia just below the surface of the skin and following the movement of the tissue. Following this, I work to lengthen and release tight muscles in the lower leg such as the soleus (it’s no coincidence that the word ‘sole’ is in the name of that muscle), the gastrocnemius, the plantaris and so on.

If you are experiencing pain in the sole of your feet, there is a high chance that it won’t go away on its own and may in fact get worse over time. Treatment is likely necessary, and can provide enormous amounts of relief. 

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