Is it worth stretching the plantar facia?
Plantar fasciitis is a painful condition that affects runners, those who stand on their feet all day and a host of other recreational sports enthusiasts. The characteristic feature is the excruciating morning pain that sufferers need to put themselves through in the first few steps getting out of bed. How can we manage this problem?
Descriptions on the cause of plantar fasciitis varies based on what you read and who you listen to. Some say it is a traction issue of the plantar fascia attachment onto the heel bone . They claim the evidence for this are the ‘bony spurs’ seen on xray of the feet of sufferers of plantar fasciitis.
Others claim that it is inflammation on the bone attachment caused by overstretch and overuse of the plantar fascia. Finally, others argue the point that degeneration develops in the attachment due to a bone compression zone (similar to how many tendinopathies develop) and over time pain develops in a similar way to how pain develops in chronic tendon problems.
Many forms of treatment have been proposed over the years such as stretching, rolling the plantar fascia over a roller, stretching and massaging the plantar fascia over a frozen water bottle , steroid injections, wearing of night socks (someone from Germany invented this), orthotics and a host of other conventional physiotherapy based interventions and non-conventional interventions.
For starters, it can be argued that over stretch is the cause of the problem to begin with. Over-pronation of the foot has often been implicated in plantar fascia problems. As the arch flattens the plantar fascia takes up a tensile force and needs to support the bones of the medial longitudinal arch. If the foot flattens over and over again, the poor plantar fascia needs to support the flattening arch. If over-stretch is the potential cause then why keep stretching it?
However, some studies have even suggested that the plantar fascia cannot even stretch. In a study by Chaudhry et al (2008), it was shown in a mathematical model that to even produce a 1% compression and shear force on the plantar fascia takes enormous forces that cannot be produced by normal means.
It almost suggests that if you attached a plantar fascia to a chain, you could pull a 1 tonne truck and it still would not stretch. So how is a night sock or roller going to be able to produce any change in length at all?
What stretching and foam rolling the plantar fascia does is either reduces pain locally as the fascia sufferer does not feel as much pain, or it changes the intrinsic foot muscles so that they provide extra support to the medial longitudinal arch.
Therefore in essence should we stretch the plantar fascia? Answer …It may help, or it may not, as long as there is no harm in trying it.
To book in to chat to us about your foot problem we have a Podiatrist and an Osteopath based at Rothery Health plus a private GP and a team of sports therapists
