Understanding Plantar Fasciitis

The foot is one of the most important organs of the human body. If there is a problem with your foot, you will find it difficult to walk. Plantar fasciitis is a common and frequently occurring clinical condition. It is a common cause of foot pain, resulting from tension-induced injury and chronic inflammation of the plantar tendon or fascia. About 10% of people will experience the pain of plantar fasciitis at some point in their lives.

What is Plantar Fasciitis?

The plantar fascia originates from the calcaneal tuberosity and extends to the fibrous tissues between the toes. It provides good protection for muscles, blood vessels, and nerve tissues. During dorsiflexion of the metatarsophalangeal joints, it pulls the heel, metatarsal bones, and metatarsophalangeal joints, increasing the arch angle and playing a crucial role in stabilizing and maintaining the arch of the foot. Plantar fasciitis, also known as heel pain syndrome, is caused by abnormal arch structure and biomechanical deviations that lead to micro-damage of the tendons or fascia of the foot, resulting in functional degeneration and ultimately causing pain and discomfort in the heel. It is the most common disease causing heel pain. Generally, plantar fasciitis is aseptic inflammation, which can sometimes be severe and persistent.

Symptoms of Plantar Fasciitis

1. Pain and tenderness on the inner side of the heel at the bottom of the foot.
2. Pain and stiffness when first getting out of bed in the morning, which gradually decreases with activity.
3. Activities such as running barefoot, walking, or climbing stairs on tiptoe can exacerbate the pain.
4. Pain intensifies with weight-bearing activities such as running, prolonged walking, or standing.
5. The severity of the pain can vary significantly. Mild pain may primarily feel like stiffness, but if the injury worsens, the pain can become more severe, including "throbbing pain" and "stabbing pain."

What Factors Can Lead to Plantar Fasciitis?

1. Age: Although plantar fasciitis can occur at any age, it is most common between the ages of 40 and 60, with no gender differences.
2. Overweight: People with a BMI (Body Mass Index) of 25-30 have double the incidence of plantar fasciitis.
3. Improper Exercise Methods: This includes excessive exercise, rapid increases in exercise intensity, and insufficient post-exercise relaxation training for the calf muscles.
4. Insufficient Muscle Strength: Research indicates that a lack of strength in the calf muscles and intrinsic foot muscles can cause greater stress on the plantar fascia.
5. Tissue Tightness: The Achilles tendon extends to the sole and merges with the plantar fascia, so tightness in the calf muscles can increase stress on the plantar fascia. The plantar fascia itself can also be tight.
6. Improper Footwear Choices: Wearing high heels for extended periods or exercising in inappropriate shoes.
7. Abnormal Foot Biomechanics: Flat feet, high arches, overpronation, supination, and hallux valgus (bunion).

How to Treat Plantar Fasciitis?

1. Extracorporeal Shock Wave Therapy (ESWT): ESWT can improve local blood circulation, reduce nerve sensitivity, and release substances that inhibit pain by altering free radicals around cells, thereby alleviating pain. It is currently the simplest and most effective treatment for plantar fasciitis.

2. Exercise Therapy: This is the main method for the ultimate recovery of plantar fasciitis patients, with a focus on strengthening exercises.

3. Triceps Surae Strengthening Exercises and Heel Raises: tart with both feet standing and raising the heels while wearing shoes with arch support, without aggravating symptoms. Progress to standing on one leg and raising the heel. Try to keep a painless state during exercise and stretch afterward. Repeat 2-3 sets daily, 20-25 repetitions per set. Finally, progress to performing heel raises barefoot.

4. Relaxing Tight Muscles and Tissues: (1) Stretching the Calf Muscles: Stretch the gastrocnemius and soleus muscles. Keep the toes pointing forward and stretch until a slight pull is felt in the calf of the rear leg. Hold each stretch for 30 seconds, 3-5 times per set, 2-3 times daily. These stretches specifically target the gastrocnemius and soleus muscles. (2) Using a Foam Roller to Relax the Anterior Tibial and Posterior Calf Muscles. (3) Stretching the Plantar Fascia: In a seated position, place the affected foot on the opposite knee. Grab the toes and pull them towards the dorsum of the foot. You can use your fingers to feel the tension in the plantar fascia and ensure it is tight. Hold each stretch for 10 seconds, perform 10 times, and repeat 3 times daily. Doing this stretch before getting out of bed in the morning can significantly reduce pain. (4) Stretching the Middle of the Plantar Fascia: While seated, gently press a fascia ball (or a similarly hard small ball) against the middle of the sole and roll it back and forth for about 10 minutes. Stop if the pain becomes severe.

Suggestions for Shoe Selection for Plantar Fasciitis Patients

1. Heel Section: Ensure a heel-to-toe drop of at least 10mm. This is to reduce dorsiflexion of the ankle ("toe-hooking" motion) during running, thus relieving stress on the Achilles tendon and plantar fascia.

2. Midsole Section: Opt for arch support with moderate firmness and good shock absorption (relatively soft).

3. Toe Section: Choose shoes with sufficient hardness to prevent excessive bending at the front of the shoe. This helps to reduce dorsiflexion of the big toe ("toe-hooking" motion), thus alleviating stress on the plantar fascia.