Pronation – Plantar Fasciitis

   Athletes are a different kind of human.  They will often endure hardships the rest of the world would shy away from in order to shave a few seconds off their time, lower their score by a few strokes, lift a few more pounds, or score a few more points in the big game.  “No Pain, No Gain” is the mantra of the athlete. However, this doesn’t always have to be the case. In fact, pain is often the body’s way of signaling to you that there is an underlying biomechanical issue that needs to be resolved.  An experienced practitioner like Dr. Drew Stabile of Stabilized Chiropractic San Rafael can help reduce pain and increase performance.

   Due to the fact that they support the weight of the entire body, and any additional weight or load the body is carrying/lifting, our feet bear the brunt of the demands athletes place on their bodies.  The most common presentation that feet will display in response to this abuse is pronation. Pronation begins when the arches in feet collapse. The arches are the primary shock absorbers for the body, and when they disappear, it puts stress on the feet themselves, the ankles, the knees, hips, and lumbar spine.  If you are an athlete that trains regularly and have extremities pain in any of these areas, and you have ‘Flat Feet’ look no further for the cause of your pain. There can be many reasons why the arches in our feet collapse. They can collapse due to obesity, overtraining, improper footwear, congenital defects, inadequate structural musculature, poor form while exercising, and repetitive trauma.

   The connection between pronation and plantar fasciitis is clear.  The plantar fascia is a flat layer of connective tissue that spans the arch between the heel and the ball of the foot.  If and when the arch collapses, the tissue gets stretched beyond its normal range. This causes microtrauma to the tissue as it tears, and the bodies response to this trauma is inflammation (the suffix –itis literally means inflammation).  Inflammation puts pressure on the peripheral nerves in the area, and as each footstep increases that pressure, the pain spikes.

   It is important to recognize that this is not black magic; your ex is not jabbing a pin in the foot of a voodoo doll in your likeness.  To understand a problem is to be empowered to resolve it. With all inflammatory processes, ice is a very effective way to reduce local swelling, and an anti-inflammatory diet can help reduce inflammation systemically throughout your body.  However, unless the athlete is planning on stopping training altogether (unlikely), a more permanent solution needs to be found. Getting properly fitted for a good pair of shoes or inserts by a qualified footwear specialist can make a huge difference.  Supporting the arches while engaging in load-bearing exercise can help prevent collapse and additional trauma to the plantar fascia. Do not order some insoles online and hope they fit properly, and this is not the time to go bargain shopping. If you train, and especially if you suffer from pronation or plantar fasciitis, good quality footwear with proper arch support is a must.  

It is also possible to restore the height of your arches if they have collapsed. Seemingly in contradiction to the prior statement, shoeless exercises can be extremely important in this effort. When we wear shoes all the time, the structural muscles in the foot, including the lumbricals, weaken and atrophy. These muscles help support the arch, and they need to be healthy and strong.  A regimen of exercises barefoot including yoga, running barefoot, and other feet exercises will quickly improve the integrity of the arch and reduce the tension on the plantar fascia. A great exercise is to stand barefoot on a towel or sheet with heels solidly planted. Then, using the toes, bunch the towel or sheet under the arch of the foot. This exercise should be repeated until the feet feel tired and the arches feel taut and can be progressed by placing a weight or heavy object on the sheet or towel to increase resistance.   However, as with all training, starting off easy and progressing to more demanding exercises is best; do not try and do a run of your normal training distance with no shoes without working up to that distance and intensity. Remember the importance of your feet and their arches. Take care of them and they will last a lifetime. Neglect them at your own peril.