What Causes Plantar Fasciitis & What Does Treatment Look Like?

Achilles Tendonopathy

Approximately 2 million people in the United States alone suffer from plantar fasciitis pain at any given time, many of whom will need plantar fasciitis treatment. Plantar fasciitis is one of the most prolific types of foot pain. About 83 percent of active adults, ages 25 to 65, will experience plantar pain at some point during their lifetime. The more active we are on hard surfaces, and the more vigorous those movements are the more likely we are to develop plantar fasciitis that needs treatment. 

 With this many people suffering, and many badly enough that they seek plantar fasciitis treatment it is worth asking ‘why do so many of us end up needing help?’. The answers to this question may  reveal the underlying reasons behind all this plantar fasciitis.  And the answers are to a large degree are environmental. SO what is it about our environment that causes all this plantar fasciitis leading to a need for plantar fasciitis treatment ? 

For a seriously long time your ancestors walked mostly on soft, uneven ground. Winding the clock back a few million generations, all of your direct ancestors (going right back to little furry 4 legged individuals who rarely sought plantar fasciitis treatment) essentially walked on soft uneven ground. 

 Soft uneven surfaces act very differently on the bodies tissues when compared with the hard flat surfaces we walk on today. 

Walking On The Beach & Your Plantar Fascia 

 Imagine a normal walk on the beach in bare feet. 

During a step, as your heel strikes the ground there is a significant amount of shock absorption, the sole of the foot is not compressed particularly hard and the outer (lateral) portion of your heel digs deeper into the sand than the inner (medial) portion. Very different to the heel hitting concrete in almost every way. 

As your full body weight transfers to the middle section of your foot sand pushes up under your arch providing arch support. This doesn’t happen on concrete or paving when you walk on them. 

As your weight bears down there is further dissipation of energy that is much greater than if you were walking on concrete. This is because you continueto  squish into sand. Imagine the difference between your skull hitting an airbag vs hitting a dashboard… but in the foot. 

Finally as you propel yourself forward with your forefoot, the outer portion once again digs a little deeper into the sand and the compression is quite mild due to the pliable surface. 

The hard, jarring stress, the compression and absence of contoured support that lead to you needing plantar fasciitis treatment are simply not present when you are walking on the beach. There is a fraction of the strain in the plantar fascia on the one hand, and stimulation of foot muscles on the other hand. 

Walking In Forest & Your Plantar Fascia 

 Imagine a walk through a forested area in bare feet as your ancestors often did.

Firstly, you probably place your feet a lot more carefully than you do if you are briskly walking down and paved urban street, thinking about making it to a meeting on time. 

When your foot does come down many of the aspects are identical to walking on sand. There will be a mixture of soil and variably decaying vegetable matter that your foot sinks into, providing significant structural support to your arch. If you walked here all day it would be very hard to develop plantar fasciitis.

plantar fasciitis free

This is about as far from walking on a street as you could be, not only is there a great deal of shock absorption, the muscles of the foot have to work quite hard. Having strong foot muscles is one of the ways in which you prevent the occurrence of plantar fasciitis that gets bad enough to need treatment.  

In the forest there is constantly changing terrain which includes different inclines and the occasional fallen limb. Safely navigating all this, requires huge amounts of muscle activity, not only your foot but also your knees and hips. You will also have a great deal of stretch going on in the foot which keeps it flexible. 

 The overall influence of walking through a forest like this on your plantar fascia is like a really great workout for the foot; with lots of firm but fair stretching and strengthening, and minimal opportunity for overloading. A perfect recipe for the prevention of having to spend all ones pocket money on treatment for plantar fasciitis.

Walking On A Street And Your Plantar Fascia 

Now imagine briskly walking along in a paved urban area in corporate footwear or fashion trainers. Perhaps your are rushing to make an appointment and possibly even texting ahead to inform someone you may be a few minutes late. 

As your heel comes down there is no give in the ground so your plantar fascia is sandwiched hard between your calcaneus (heel bone) and the firm sole of your shoe. 

The lack of squish in the ground means that your heel cannot dig deeper on its outer ‘lateral’ side which tilts the foot inwards begging the arch to collapse. To prevent this collapse your gluteal muscles have contract much harder than they would in this moment on softer ground.

cause of need for plantar fasciitis treatment


As your mid foot arrives at ground level there is no flexibility in the surface, so no significant arch support forms like it did on the beach or in the forest further begging the arch to collapse. Even high arches drop under these conditions. 

As you propel yourself forward with your forefoot there is still no ‘give’ in the ground so your plantar fascia is compressed severely once again as your body weight shifts forward. 

You are probably moving way quicker than you did when you were on the beach or in the forest because it’s so easy without changing terrain, this means the ground forces in the plantar fascia  are further magnified. This kind of stress is many many times the natural amount and forms a perfect trigger for plantar fasciitis in itself.

The hardness and flatness of the ground means there is also not much need to balance or much stimulation of the leg and foot muscles, and they don’t get much of a workout which makes the system lazy. 

Now repeat this cycle 12 thousand times per day.  Is it any wonder that treatment for plantar fasciitis becomes a topic for so many of us at one time or another ??? 

Plantar Fasciitis In The Modern World

Even if some of the details of what I have described above were hard to picture for you; I hope you at least got a general sense of what hard modern surfaces inflict on your plantar fascia, and on the likelihood of you needing treatment for plantar fasciitis. 

 There is a huge increase in stress in your poor feet if you live in an urban environment, on top of that they tend to become weak in these environments which renders them somewhat defenceless against the likes of concrete. 

 In a sense we could say that overwhelmingly it is sugar that leads to us needing treatment for dental pain. In the same spirit we can say that it is hard flat industrially manufactured surfaces that lead us to needing treatment for plantar fasciitis. Hopefully though, we make these statements with keen awareness that regardless of our diet and our environment there is MUCH that we can do to care for ourselves. We eat more sugar than ever now, and yet we have a fraction of the tooth decay we did 300 years ago after all !!! 


 The Steps To Effective Plantar Fasciitis Treatment? 


Plantar Fasciitis Pain Treatment – Step 1. 

 Purchase some large machinery, systematically remove all concrete, tarmac, paving, tiles, hardwood floors and stone flooring from the planets cities that you intend to spend time in during your life (jokes). 


Plantar Fasciitis Pain Treatment – Real Step 1. 

Hire a professional to remove all scar tissue and from plantar fascia and promote blood flow using hands on treatment methods. 

Some combination of acupuncture/acupressure/scraping/percussion/ stretching is likely to work for you. The key is having a practitioner who is willing to throw the kitchen sink at your problem, this is because scar tissue can be stubborn stuff.


Plantar Fasciitis Pain Treatment – Real Step 2 

 Gain deeper insight into your foot biomechanics to better understand what movement patterns triggered the scar tissue to form where it did in the first place, and further guide plantar fasciitis treatment options. 

 Further investigation into foot biomechanics can be done in person using computerised Gait Analysis or remotely using photographs and impressions taken in a foam box and posted to a practitioner. 


Plantar Fasciitis Pain Treatment – Real Step 3 

 Correct and ease  your foot mechanics with a combination of exercises to specifically strengthen weak muscle groups,  and custom orthotics to provide natural arch support that mimics natural surfaces. 

 By way of example, one of the classic patterns I often see in my clinic, that leads to the need for plantar fasciitis treatment pain, is the combination of high arches and glutes that aren’t firing effectively. This combination is bad for the plantar fascia. 

In this instance we prescribe ultra-specific glute strengthening exercises and custom orthotics to fit the arch. In this way we are able to effect long term change in the exact cocktail of biomechanics issues that left the foot open to repetitive strain in the first place. There are many other such examples of plantar fasciitis treatment that are customizable to the individual. 

Closing Thoughts 

The world we have created for ourselves is pretty great. We don’t have to worry about getting wet too often, let alone grizzly bears attacking us and honey badgers eating all our rhubarb. And yet the modern world is as imperfect as anything else in life. It has made us frail and soft compared to what nature intended for us, and it has also beaten the hell out of our feet, knees, hips and spines with its hard ground. Plantar fasciitis is just one of the issues that arises from this issue. 

successful plantar fasciitis treatment

no plantar fasciitis and no grizzlies.. cause for a high 5

Regardless of what life is going to throw at your plantar fascia there is plenty of scope for healing. We don’t all get plantar fasciitis after all. Resolving the pain and scar tissue that has built up in your foot, and then addressing the underlying biomechanical causes you can take control of your pain and find lasting relief. This is a comprehensive strategy for plantar fasciitis treatment

 So now you know why so many of us need plantar fasciitis pain treatment and you also know what comprehensive and effective plantar fasciitis treatment looks like. 

 Neat & Tidy ! 

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