Did you know that Plantar Fasciitis starts in your lower back?
Plantar fasciitis is a very painful condition—I’ve had it, and it’s awful. It’s considered to be a disorder of the connective tissue that supports the arch of the foot.
However, the pain and inflammation that occurs in the plantar fascia is just a symptom of a full-body pattern of muscle tension that starts in the lower back.
No amount of rest, icing, or wearing arch supports will cure your plantar fasciitis if you don’t address the larger pattern of tension that’s causing the problem. Luckily, the scientific community has started exploring the relationship between plantar fasciitis and pain and dysfunction in the lower back.
Researchers at Des Moines University and the University of Wisconsin published a study in 2017 exploring the association between lower back pain, lower back dysfunction, and plantar fasciitis. They hypothesized that “Lack of response to plantar heel pain (PHP) treatment may be related to unmanaged low back pain (LBP) and low back dysfunction.”
The study found a significantly higher rate of lower back pain among people with plantar heel pain than among controls; 74% of people with plantar heel pain had lower back pain, as compared to 37% of controls. People with plantar heel pain also had 17% higher levels of low back disability than controls. The researchers concluded that treatment to address lower back pain and disability may be advisable in order to successfully improve plantar heel pain.
What is Plantar Fasciitis?
The plantar fascia is a thick band of connective tissue that runs along the underside of the foot, from the heel bone to the metatarsals. Its function is to support the arch of the foot by carrying tension when the foot bears weight.
When too much is demanded of the plantar fascia, the tissue can become inflamed, degenerate, and very painful.
The underlying cause of Plantar Fasciitis
Our muscles, tendons, ligaments, and bones create a complicated pulley system throughout our body. No part of our body moves independently; movement or tension in one part of the body always affects other parts of the body.
When it comes to plantar fasciitis, tight lower back muscles—the quadratus lumborum and erector spinae group—pull the top of the pelvis and lumbar vertebrae closer together. This typically brings the pelvis into an anterior (forward) tilt. Tight hip flexors will also tilt the pelvis forward, and often play a role in plantar fasciitis.
An even amount of tension across the lower back might translate into plantar fasciitis pain being experienced equally in both feet. But many people have one side of their lower back or one hip that’s tighter than the other.
Imbalanced tightness in the lower back muscles, iliopsoas, and even the obliques can result in us experiencing plantar fasciitis pain more in one foot than the other. That’s what happened with me, and it took me a long time to figure out that my tight iliopsoas on my right side was hiking my right hip up, causing tightness all the way down my right leg that resulted in plantar fasciitis pain in my right foot.
So, when our pelvis is tipped forward, or when one hip is hiked up, our hamstrings get pulled tight. Our hamstrings originate at the bottom of our pelvic bone, run down the back of our thighs, and insert at the tops of our tibia and fibula, the bones of our lower leg.
The tension in our hamstrings pulls on the bones of our lower leg, trying to flex (bend) our knees. This attempt to flex our knees recruits the muscles of the lower leg that flex the knees as well—the gastrocnemius and the plantaris.
The gastrocnemius and the plantaris attach to the calcaneal (Achilles) tendon, which attaches to the heel bone. So when these muscles are tight, they not only flex the knee, but also plantar flex the ankle.
This finally brings us to the plantar fascia, the thick band of connective tissue that runs from the heel bone to the base of the toes, supporting the arch of the foot. When the ankle is plantar flexed, the muscles and connective tissues on bottom of the foot are tightened.
If all of this occurred while we were lying down, we probably wouldn’t feel any negative effects. But if this pulley system I’ve described is chronically tight, and we spend a lot of time on our feet, pain in the plantar fascia is almost inevitable: it’s bearing the weight of our entire body while being pulled tight.
Why do we develop this pattern of tightness?
We develop chronic tightness in our muscles as a result of muscle memory. Throughout our lives, as we repeat postures or movements, we start to build up residual muscle tension in the muscles involved in those patterns. It happens so gradually that we usually don’t notice we’re slowly tightening up until one day, we feel pain.
Unfortunately, most health professionals don’t understand how full-body patterns of tension can cause pain or symptoms to be felt in just one area. So they use spot treatments, which focus on just the painful area. These spot treatments typically have little lasting effect because they don’t address the underlying cause of the problem: the way we’re using our entire body.
So, how can I cure my Plantar Fasciitis?
The way to actually cure your plantar fasciitis for good is to address the entire pattern of tension that’s resulting in your plantar fascia becoming strained, inflamed, and painful.
Clinical Somatics exercises reduce the resting level of tension in your muscles being set by your nervous system. The exercises retrain your muscle memory, allowing you to change deeply learned posture and movement patterns and stop doing damage to your body.
The Level One & Level Two Courses together address the pattern of tension that results in plantar fasciitis pain.
In addition to practicing Clinical Somatics exercises on a daily basis to release your muscle tension, you should:
Vary your activities and types of exercise.
Vary your footwear, and don’t wear high heels.
Try to reduce time spent on your feet. If you work on your feet, take frequent breaks.
Put your legs in the air against a wall; this is great for circulation and relieving swollen, inflamed feet.
Stop doing any deep, static stretching. Read this post to learn why stretching doesn’t work, and can actually make muscles tighter.
The most effective exercises for Plantar Fasciitis
The following exercises from the Level One & Two Courses work directly with releasing the tight muscles that cause plantar fasciitis. Keep in mind that other exercises throughout the courses will be helpful for you as well, especially if you have tight obliques, hip rotators, quadriceps, or iliotibial bands.
LEVEL ONE COURSE
Arch & Flatten
LEVEL TWO COURSE
Lower Back Release
Proprioceptive Exercise 1
Standing Hamstring Release
Seated Hamstring Release
The Pain Relief Secret: How to Retrain Your Nervous System, Heal Your Body, and Overcome Chronic Pain by Sarah Warren, CSE
Somatics: Reawakening the Mind’s Control of Movement, Flexibility and Health by Thomas Hanna