Plantar fascitis or heel spur pain is a stubborn issue to get rid of.  Plantar fascitis’ classic symptom is a searing or tearing pain on the bottom of the foot when you first wake up and walk which then resolves after more walking. Anything with “-itis” after it simply means inflammation. So plantar fascitis is an inflammed plantar fascia. Like many medical labels, this term does not describe the underlying reasons for plantar fascitis. Hence you see all sorts of remedies out there which have little effect.

Typically heel pain presents as an exquisite tenderness on the heel when walking. It’s often referred to as heel spurs. Both diagnoses are somewhat related because of their anatomy. In order to get rid of these issues it’s important to understand why they occur.

The plantar fascia is  a broad fibrous tissue on the bottom of the foot, extending from the heel to the toes. Fascia isn’t like a muscle–it doesn’t contract on its own. It merely stretches slightly and then rebounds like a tough rubberband. Pointing blame at the plantar fascia is like yelling at the bowling ball that just dropped on your foot. It’s not the bowling ball’s fault, it’s your hand’s fault for letting it go. In plantar fascitis, the plantar fascia is just responding to abnormal stresses being placed on it.

The purpose of the plantar fascia is to assist with the spring-action of the foot. When you step on the foot it slightly flattens out. As your body passes over the foot, it springs back into shape with the help of the plantar fascia. Understanding this will help you visualize how to fix the problem.

There’s a multimillion dollar industry out there making products to stretch the plantar fascia. These products evolved because of the tearing feeling in the morning on the bottom of the foot during those first steps. Well, if there’s tearing, then the fascia must be too tight, right? Wrong. The plantar fascia merely returned to it’s normal length during the night and your foot excessively flattened out while walking which abruptly stretched the plantar fascia. Stretching the fascia during the night won’t correct the underlying problem–that of a collapsing foot.

Heel pain typically occurs near the insertion point of the planar fascia on the heel bone. I’ve found heel pain occurs in people with a history of plantar fascitis or that plantar fascitis follows heel pain. Both are caused, and helped, by the same thing.

So what’s at the bottom of these issues (so to speak)? The problem actually has to do with a third issue we haven’t mentioned yet. There is a muscle deep to the plantar fascia called the flexor digitorum brevis . This muscle runs from the heel bone to the toes and helps maintain the arch of the foot (see figure below). It supports the plantar fascia. When this muscle begins to fail, the foot flattens more than it should, stressing the plantar fascia and its insertion at the heel. Strengthening this muscle has fixed the majority of the plantar fascitis and heel pain patients I’ve seen.

Flexor digitorum brevis (Copyright 2009 Boone Publishing, LLC)

How to do this? It’s simple. Sit down with a towel under your foot. Now scrunch the towel with your toes keeping the heel down on the floor. Bunch it up under your arch and then spread it back out to start again. Repeat this 3 times. Perform this 5-10x per day for one week and you should feel a significant difference in your pain. You can also do this while standing, scrunching the toes up in your shoe. No one will even know you’re doing it.

The reason you need to do so many repetitions and sets is because each step you take, lengthens and weakens the flexor digitorum brevis muscle. You take many steps during the day so you’ll need to perform a lot of repetitions to counter that. After a week of this, your muscle should be on its way to restoring its normal length and tension.

This information and exercise can be found in my book, Fixing You: Foot & Ankle Pain. Let me know how it goes!