What is Plantar Fascia – by: Newton Running Athlete Dr. Mark Cucuzella
Plantar Fasciitis is the common term for what should be more accurately termed Plantar Fasciosis. itits is an acute inflammation caused by a trauma or infection. osis is chronic degenerative condition.
No evidence exists for an ideal treatment of this condition without identifying and treating the causes, which can be many. Since we have minimal quality literature to guide us, this advice comes from seeing hundreds of runners and guiding them in self corrections as well as an understanding of the basic anatomy and natural functioning of the foot.
What is the Plantar Fascia?
The plantar fascia (PF) is a strong ligament that runs from the heel to the metatarsal heads in the front of your foot. This ligament helps absorb the shock that occurs when your foot contacts the ground. It has function in the windlass mechanism recreating the arch on takeoff.
What is the Cause of Plantar Fasciosis?
The PF is not designed to manage the majority of the load of running and walking. The intrinsic and extrinsic muscles of the foot are designed to receive signals from the fascia and in turn manage the majority of the load. When those muscles are dysfunctional the load gets transferred to the PF which is unable to handle it likely leads to tears or plantar fasciosis.
The may not just be Fascia. The pain often localizes to the inside front edge of the heel. There are muscles that share an insertion with the plantar fascia. The flexor digitorum brevis muscle runs directly above the plantar fascia. On the inside part of the heel the abductor hallucis, an important arch stabilizer muscle, attaches. (see image below)
The tendinous insertions of these muscles might play a role in this painful condition.
You can repair these tears by using passive methods such as rest and bracing but as soon as you hit the road or trail again you will likely suffer the same process. The only way that you can actually fix plantar fasciosis is to address the root cause.
Several Structural Causes can contribute to the Problem
- Weak intrinsic muscles of the foot
- A misaligned and weak first toe
- Tight shortened calf muscles
- Tight plantar fascia
- Poor neuromuscular reflexive function of the foot- proprioception
A great read on “The Foot Core” can be found here with link to full article with Dr. Irene Davis
Other Important Contributors
- Increased mechanical stress from the amount of running or activity
- Adapting too fast from supportive footwear which inhibits intrinsic muscles to flat shoes or barefoot (i.e. summer if going quickly into flip flops or barefoot)
- Poor walking and running mechanics
- Overly supportive footwear leading to instability. This is a paradox as shoes that over support will weaken the foot which in turn leads to the foot’s instability.
Stay tuned for Part 2 on how to treat Plantar Fasciitis.
Dr. Mark Cucuzzella is a Professor at West Virginia University School of Medicine. He is also a Lt. Col in the US Air Force designing programs to promote health and better fitness in the military with the USAF Efficient Running Project. (available on iphone format here) In military and civilian community he has been a tireless promoter of healthy movement, nutritional interventions in patients with any spectrum of the metabolic syndrome, and injury free training for running. To learn more about Dr. Mark Cucuzella, check out his Newton Running athlete page, here.