Plantar Faciitis is the most common condition of heel pain. It occurs when the long fibrous plantar fascia ligament along the bottom of the foot develops tears in the tissue resulting in pain and inflammation. Inflammation develops when tears occur in the tissue. The pain is usually located close to where the fascia attaches to the calcaneous, the heel bone. The plantar fascia ligament is made of fibrous bans of tissue and runs between the heel bone and your toes and stretches with every step.
Fascia tissue is located throughout the body, usually providing support to the musculoskeletal system, providing rigidity, much like guide wires support a cell phone tower. Together with ligaments and tendons, fascia allows our body system to be mobile. Plantar fascia (foot fascia) originates on the base of the heel and runs across the arch of the toes. The primary function of the plantar fascia is to support the arch of the foot.
With each step, the load of the body weight is applied to the arch causing the arch to drop. This drop in the arch makes the ball of the foot and the heal want to spread further apart. The fascia in the foot goes into tension to resist this force. If this tension in the fascia is greater than the fascia can handle, the fascia is damaged and the area will become inflamed.
The intrinsic load stems from the muscles contracting to move the foot. Much of the intrinsic load applied to the fascia results from the calf muscles. The plantar fascia is part of a larger structure termed the CT band ( CT is an acronym for Calf to Toes ). The main components of the CT band are the calf, Achilles tendon and plantar fascia. All these components are linked so that tension on any part of the CT band increase tension in the entire system. Of the 3 components of the CT band, the plantar fascia is the weakest link.
Extrinsic load refers to all the other loading factors in the plantar fascia other than the intrinsic load. Some of these factors are body weight, frequency of steps, duration of standing.
Plantar fasciitis is a form of repetitive stress injury. While supporting the load, the fascia creates tiny microscopic tears in the tissue. This is completely normal, In a healthy foot, the foot is able to repair itself at a greater rate than the damage it absorbs. As long as the amount of damage is lower than the body's ability to heal itself, the foot will remain healthy. Plantar fasciitis occurs when the sum total of damage is larger than the amount of healing the body can perform in a day. The foot is used so much in the course of the day that once the amount of damage exceeds the body's ability to repair itself, the pain will tend to persist.
To simplify this, the foot pain you feel when you get up in the morning exists because you caused more damage yesterday than your body could heal last night as you slept.
Stretching is a biomechanical method to help with heel pain. Stretching the calf elongates the tissue in the CT band and reduces the amount of tension helping to re-balance the normal biomechanics of the foot and leg. This reduction in tension lowers the amount of damage created during normal walking activity.
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