Plantar Fasciitis Symptoms
I personally tore and then ruptured my left foot's abductor hallicus and plantar fascia. I have a good idea as to how plantar fasciitis develops and
there are differences in having a chronic case or a traumatic injury case. Both seem to usually respond well to the same treatment methods. Read
below to see where you fit in. Most people that are not athletic (or had a traumatic injury to the heel) will have the "chronic onset" form of plantar
fasciitis. I had both types in one foot. My injury was the worst of the worst and then some.
Trigger points can be caused by many things and can mimic plantar fasciitis. If you have plantar fasciitis, on the other hand, you will have trigger
points no matter what.
Keep this in mind:
There is a difference in treatment between these two. Chronic onset plantar fasciitis needs a new inflammatory response to kick start the healing
process again and to stop the degeneration. This is done with transverse friction massage/graston/eswt aka scraping techniques. When you try to
treat a severe injury caused by trauma to the plantar fascia, you need to focus less on the degeneration, and more on the healing aspect, such as
rest/systemic enzymes/taping and so on.
Chronic Onset:
- Starts out slow, first it is a ghost of a pain, and every day it seems to get worse until it is completely unbearable. Pain can progress to be gradually worse over months
- Pain with first steps in the morning
- Extreme pain in heel/arch can be dull or and horrendous ache
- Redness/Swelling/Heat/Sensitivity in heel
- Dull ache in arch possible. Most common is extreme pain in heel
- Sharp/dull pains that can move around the bottom of the foot
- Pain after standing up from sitting/laying down for extended amount of time
- Pain can subside for some after the first steps, but then more pain from extended walking there after
- May have flat feet
- May have collapsed knees going inward
- Probably has anterior pelvic tilt
- Usually has an unhealthy diet
- Sedentary lifestyle likely
- Heel spur possibly there, but this is not conclusive
- Can feel like a bruise on the heel. Some report that it feels like "stepping on a rock"
- Can cause a limp
Usually caused from sitting down all day, causing the body to adapt to
that position, which causes the pelvis to shift anteriorly, femur internally
rotates, knees collapse inward, causing the foot's arch to collapse. This
set up is just asking for plantar fasciitis. DO NOT SIT IN A CHAIR FOR
LONG!!! Get up and walk around often!
Also, sitting causes the hamstrings to tighten and become dysfunctional
from adapting to the sitting position, which makes the calves tight (they
share the same myofascial kinetic chain, click here to learn more), which
causes excess stress to the plantar fascia. Tight hamstrings mean added
tension to the plantar fascia.
Wearing shoes causes plantar fasciitis because it makes the foot
musculature weak. When the muscles cannot support your body weight,
then the plantar fascia takes the grunt work and cannot handle the
stress and responds with degeneration (more on this by clicking here).
Inflammation is not technically present in the plantar fascia in chronic
cases. Inflammation is in the surrounding tissues around the plantar
fascia. These inflamed tissues cause hypersensitivity to pain signals in
the nerve fibers around the plantar fascia. What is going on in the
actual plantar fascia itself is degeneration. The plantar fascia has given
up on healing and is eating itself up so to speak.
Can also be caused by lack of circulation due to a muscle that moves the
big toe becoming dysfunctional due to being inside a shoe. The muscle
cannot do its job and can cause nerve entrapment and blood flow
restrictions. Less blood flow equals less muscle strength and endurance
and causes more stress to the plantar fascia due to the plantar fascia
taking up more "grunt work" that the muscles are unable to do.
Severe Injury Onset:
- Caused by a sudden trauma to the heel causing partial or complete rupture of the plantar fascia. Can hear a "pop", but not always
- Pain all day long, from morning to night
- Extreme localized pain. Usually much sharp as compared to chronic onset
- Redness/Swelling/Heat/Sensitivity
- Sharp pain in arch and heel present, can spread after a week to a dull pain in surrounding structures
- Pain is still the same usually whether you have sat down for a long time or for a short time
- Pain becomes worse the more you walk. Can be much worse at the end of the day
- May have flat feet, but not always
- May have collapsed knees going inward, but not always
- May have anterior pelvic tilt, but not always
- Can have a healthy/unhealthy diet. Depends more on the trauma inflicted to the plantar fascia
- Can cause a limp
Partial tears can be hard to treat. Usually treated in the same way as
chronic onset. The rest is required after the injury.
Excessive running on hard surfaces with bad shoes, being overweight,
having bad posture and body mechanics and many other factors can
make it more likely that you will tear your plantar fascia after trauma to
the heel.
Minutes after a traumatic injury to the plantar fascia, trigger points
develop in the muscles around the heel. At first these are good, and you
should rest while you have these trigger points. After a couple weeks,
these need to be released. The plantar fascia can heal if you rest it after
a traumatic injury, but you want to be sure to try your best to avoid the
plantar fascia from going into "chronic degeneration mode". After the
injury is fixed in the plantar fascia, you need to fix the dysfunctional soft
tissues around the heel (more of this in my book).
You can recover from this injury if you rest and slowly go back into your
activities. If you push through the pain and limp around, it will get worse
extremely fast and turn into a chronic case of plantar fasciitis. You want
to avoid this. This can ruin a couple months to years of your life, and
you will regret not resting when you had the chance.
You can use a walking boot, but not for long (they cause lack of
circulation which causes oxidative stress and atrophy of the lower
extremity). If you have a full rupture or a big tear, you may need to see
an orthopedist. If not, just follow the usual treatment as outlined in my
book or on the many articles in this website.