Some of you may have read the recent New York Times article entitled “No Consensus on a Common Cause of Foot Pain.” The article outlines how chronic plantar fasciitis is not a fasciitis at all but rather a fasciosis. The difference is meaningful. The suffix “itis” means inflammation whereas the suffix “osis” means degeneration. Biopsies of fascial tissue from subjects with chronic plantar fascia pain contained virtually no inflammatory cells at all but rather degenerative tissue.
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What should you do if you have chronic plantar fascia pain?
The key to treating chronic plantar pain is two-fold. The first part is to promote healing of the damaged area. This can be achieved with a combination of massage, strengthening and stretching. Whereas light to moderate pressure has been found to have NO impact on repairing degenerative tissue, deep tissue massage has been shown to promote healing of damaged tissue (3). We recommend a combination of professional massage from a skilled therapist and self-massage at home. Eccentric strengthening and stretching exercises have also been found to to repair degenerative tissue (4). We recommend heal drops off the edge of a stair combined with a few theraband exercises.
The second part to treating chronic plantar pain is to undertake a thorough evaluation to discover why the plantar was injured in the first place. This is imperative to prevent the problem from returning. Possible underlying causes may include tight calves, tight hamstrings, joint restrictions of the foot and/or ankle or fallen arches just to name a few.
For more information or to schedule an appointment contact SMI today!
Sincerely,
Mark Fadil
Executive Director
Sports Medicine Institute
(1) Benno Brinkhaus, Miriam Ortiz, Claudia M. Witt, Stephanie Roll, Klaus Linde, Florian Pfab, Bodo Niggemann, Josef Hummelsberger, András Treszl, Johannes Ring, Torsten Zuberbier, Karl Wegscheider, Stefan N. Willich; Acupuncture in Patients With Seasonal Allergic RhinitisA Randomized Trial. Annals of Internal Medicine. 2013 Feb;158(4):225-234.
(2) Gerald Heart and coworkers, Science, 23 March 2001
(3) Gale M. Gehlsen, “Fibroblast responses to variation in soft tissue mobilization pressure”, Medicine & Science in Sports & Exercise, Apr. 1999, Vol. 31, No. 4, pp. 531-535.
(4) Brett L Woodley, Richard J Newsham-West, G David Baxter. “Chronic tendinopathy: effectiveness of eccentric exercises,” Br J Sports Med. 2007 April; 41(4): 188-198.