plantar fasciitis

[food62lover]

I have severe plantar fasciitis. I cannot spend much time on my feet. u want to be physical, any tips?

[MrNiceGuy]

Good afternoon, food62lover.

Are you aiming to reduce pain and discomfort caused by plantar fasciitis, therefore, improving overall foot function, or do you seek a largely non-weight bearing programme of exercise (or both)?

Concerning plantar fasciitis, which is increasingly considered a degenerative condition, not inflammatory (1), it'd be interesting to learn how long you've suffered with it and what interventions you've previously tried/been prescribed to alleviate symptoms and improve normal function of the plantar aponeurosis itself.

Although continued tensile strain upon the plantar fascia remains the key mechanical 'feeture' in the development of PF (1), there are many other factors to consider too, ranging from age, BMI and existing comorbidities (hypertension/diabetes) to reduced foot muscle strength and altered foot posture (collapse of medial longitudinal arch), hence why no gold standard of treatment for plantar fasciitis currently exists (2).

For example, through impaired blood flow, hypertension has been shown to result in posterior tibialis dysfunction (3) - an extrinsic foot muscle responsible for supporting the plantar fascia in preventing total collapse of the foot. Therefore, in addition to improving post-tib weakness/dysfunction through gradual and controlled loading of tissue, (again, I'm not making assumptions) need also exists to address hypertension through diet and exercise.

As for exercise, since dynamic load-bearing activity evidently exacerbates PF symptoms, the most important thing is to discover an alternative that you enjoy. The obvious CV alternatives are cycling and swimming (pool or open water). Resistance exercise, however, could take the form of floor based, low intensity isometrics (think wall sits and glute bridges) or banded resistance to improve strength/improve lean mass and joint mobility, while also including exercises (such as the short foot (4) or calf raises with toes in extension (5) to improve foot function and reduce severity of plantar heel pain.

Sources:

(1). Evaluation and Treatment of Chronic Plantar Fasciitis: doi.org/10.1177/2473011419896763

(2). Musculoskeletal and activity-related factors associated with plantar heel pain: DOI: 10.1177/1071100714551021

(3). Prevalence and Associated Factors of Flat Feet among Patients with Hypertension: DOI: 10.26502/fapr0016

(4). Effect of Short Foot Exercises on Foot Posture, Pain, Disability and Plantar Pressure: DOI: 10.1123//jsr.2018-0363

(5). High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up: doi: 10.1111/sms.12313 (click on pdf symbol to view full article).

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