When Heel Pain Isn't Coming From Inflammation

Understanding the Difference Between Plantar Fasciitis and Plantar Fasciosis

Heel pain is often called plantar fasciitis, but ongoing discomfort DOES NOT mean inflammation is the problem.  The phantom heel spur you are shown on an x-ray is actually a normal bony protuberance on both feet of every human being and NOT a cause of plantar fasciitis.  The fact is that inflammation is a beacon of healing and NOT a cause of heel pain.  In chronic cases, the plantar fascia undergoes degradation that is not helped by stretching, but can absolutely be worsened by traditional stretching, icing, and anti-inflammatories. This common treatment approach found on the internet and in many providers offices is actually a cause of further plantar degradation. 

While reducing flare-ups remains an important part of recovery, improving flexibility within the calf and foot muscles through treatments such as Active Release Technique (ART), Active Isolated Stretching (AIS), a specific Low-Dye taping with RIGID cloth tape and a specific strength training approach to load healthy forces onto the fascia will allow the fascia to remodel and strengthen.  Understanding the conditions helps explain why restoring muscle length often becomes an important part of treatment.

Plantar Fasciitis Isn't Always the Whole Story

The plantar fascia (actually called the plantar aponeurosis) is a thick band of connective tissue that runs from the heel to the toes, helping support the arch of the foot during standing, walking, and running. Plantar fasciitis generally describes an earlier stage of injury involving a tugging irritation and breakdown of the attachment on the heel. 

Plantar fasciosis develops after repeated stress causes chronic changes within the tissue itself. Although both conditions can produce similar heel pain, the condition of the plantar fascia has changed, making it important to understand how to properly place stress on the tissue.

Reducing Strain With Active Isolated Stretching (AIS)

Active Isolated Stretching (AIS) focuses on improving flexibility within the calf muscles in order to properly lengthen the muscle without pulling at the heel as you will when doing traditional stretches using your bodyweight.  Placing your full weight onto the fascia is what has been causing the breakdown.  Stretching too aggressively is one of the major causes of plantar fasciitis, not a fix.  Patients determined to stretch their fascia will continue to worsen the condition.

Patients also learn stretches they can safely perform at home at specific times of the day, allowing them to continue their progress between visits. Combining in-clinic treatment with a home stretching, strengthening, and taping routine provides ongoing support as recovery is allowed to accelerate.  

Why the Calf Muscles Matter

The gastrocnemius and soleus muscles absorb the force needed when standing, walking,  running and jumping.  When the muscle cant absorb the forces applied, the extra stress travels into the foot and places the same excess load onto the fascia (plantar aponeurosis) that acts as a last line of shock absorbing when hitting the ground.  

Don't Overlook the Muscles Within the Foot

The foot contains more than 15 small muscles that help support the arch and stabilize the toes during movement. Muscles such as the flexor digitorum brevis, abductor and adductor hallucis, quadratus plantae, and multiple interossei & lumbricals work continuously to help the foot adapt to changing surfaces while maintaining balance.

When these muscles lose flexibility, they may not support normal foot mechanics and lead to plantar fasciitis, metatarsalgia, neuromas and stress reactions.  Restoring muscle length throughout the foot helps improve how these structures work together while supporting healthier loading through the plantar fascia.

Help Your Feet Move More Comfortably

Chronic heel pain deserves more than symptom management alone as the traditional treatment approach has been shown to actually worsen and prolong the condition.  Addressing muscle tightness within the foot and calf will reduce loading on the plantar fascia as recovery progresses. Contact Performance Care Stretch Clinic to learn how to properly manage plantar fasciitis once and for all.