PLANTAR FASCIITIS - Description and Cause
Description and cause. Treatment. Prevention.
This injury is considered a common complaint among runners. By some sources it affects only about 8% of runners, nevertheless it seems to be a very well-known injury for most of them, which is confirmed by Pose Tech Forum discussions. Thus, we return to the topic again.
Modern medical community doesn't support our approach to solving this problem by changing one's running technique and neuro-muscular patterns. Instead they offer some conservative treatment with cortisone shots, pills, different kinds of physiotherapy: massage, exercise therapy, etc. Another option is surgery.
Though they use the word "prevention" in one of their approaches, in reality they do not suggest any preventive methods, but only treatment as a post factum reaction to the received injury. We'll discuss this controversy later and see what could be done to solve the problem.
Plantar fasciitis (PF) is an inflammation and pain of the plantar fascia -"the connective tissue that runs from the base of the toes to the heel bone and supports the bottom of the foot." "The site of injury, according to Tim Noakes, is almost always at the attachment to the heel bone". The usual symptoms are: pain as from a bruise under the heel, pain first thing in the morning going out of bed, pain after training sessions, in severe cases it doesn't allow one even to walk normal.
The cause of PF, according medical experts, is intensive sport activities, where distance runners are considered by far the most likely candidates for this condition; also athletes with feet pronation, flat feet, high arches, those who run with their feet rolling and thus over stretching and over loading tendons. Over time repetitive over stretching and over loading, will obviously lead to overuse injury. The list of causes could be extend by athlete's anatomical abnormalities, flexibility deficit, wrong shoes.
From the last statement I would accept over stretching and over loading as one of the main causes of plantar fasciitis. In my opinion, it comes from the wrong movement, or wrong technique, where the use of internal and external forces becomes inefficient and contradictory to the needs of motion.
What does it mean inefficient and contradictory to the needs of motion? In the layman language it means that the forces are made to work against each other and our bones and soft tissues (muscles, tendons, ligaments) serve as the place of application of these forces. As we know, each force is a vector, i.e., it is directed somewhere. In order to make the motion efficient, smooth, and powerful, it is necessary to point the forces' vectors in one, desirable direction, or at least, provide for the involved forces to be not working in the opposite directions.
So when the body weight (gravity) is moving down during the support time, our foot, and all related muscles, should not exert any efforts in the opposite direction to move the body up or abruptly stop the downward movement. These negative efforts are manifested in some wrong motions such as push off efforts, when the foot works as a leverage in order to "propel" the body forward. During this motion, plantar fascia tendon becomes the major acceptor of the body weight moving down and also of the foot efforts trying to push the body in the opposite direction. So, instead of one force we apply two forces working in the opposite directions to one and the same tissue and double the load on the plantar fascia tendon. When this motion is repeated thousands and thousands times, then we are facing or experiencing an overuse injury.
We'll continue on this topic next week and focus mainly on its treatment and prevention.
Dr.Romanov
