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  • Writer's pictureHoxton Pilates

Plantar Fascia

Plantar Fascia (also known as plantar aponeurosis) is a strong fibrous band of tissue on the bottom of the foot. It extends from the heel bone (or to be precise the calcaneal tubercle) to the base of the toe bones (proximal phalanges).

Fascia is tissue mainly composed of collagen that occurs throughout the body in a variety of guises. There is fascia extending under the surface of the skin and lining the nuclei of cells. Fascia surrounds all muscles, bones and joints and is the substance referred to as 'silver skin' in meat. There is fascia encasing the viscera (vital organs) and brain, and it also lines arteries and blood vessels. The fascial network provides structure, protection, communication and a degree of movement throughout the body. Furthermore all fascia is innervated and is highly sensitive. In a way it is your body's world wide web, allowing information to feedback and feedforward in an instant. The plantar fascia therefore is key to our connection to the ground we walk on.

There are three arches in the sole of the foot: the medial, lateral and transverse. Together they form a triangle. The medial arch runs longways down the inside foot and the lateral arch runs longways down the outer foot. These two arches meet at the base of the heel at the back and connect to the transverse arch at the front. The transverse arch runs crossways just at the base of the ball of the foot. The plantar fascia is what forms the medial arch, and it is the literal spring to your step. The three arches form a truss. As you step, vertical forces from the tibia (large lower leg bone) flatten the medial arch: stretching the spring so to speak. Ground forces traveling upwards further flatten the arch, then as you roll through the foot the elastic force propels you forward like a slingshot. This is also known as the "windlass mechanism". Every step is like bouncing along on your inner trampoline. In fact, muscle effort in the legs and hips is far less influential in the gait cycle than the energy potential stored in bouncy plantar fascia

Plantar Fasciitis is inflammation of the plantar fascia. Considering the structure of the foot and the function of the plantar fascia it is clear that the health of this tissue is vital for functional movement. The failure of the fascia to be springy and resilient will potentially result in pain and imbalance throughout the legs and pelvis. Symptoms of plantar fasciitis include pain in the heel or in the arch, particularly first thing in the morning. Think of those painful stiff steps as you crawl out of bed sometimes (maybe after a marathon or a night in high heels). Cramping in the feet or toes is also common, and sometimes there is a lump near the base of the heel where the medial arch begins. The causes of plantar fasciitis usually stem from the foot not moving enough through its full range of motion. This can be due to a lack of walking or too much standing still, but it can also arise from too much walking with inflexible shoes on hard paved surfaces. Conversely if the plantar fascia moves too rigorously and relentlessly through its range of motion as in the case of an athlete or ballet dancer, this too can cause inflammation. Clearly many factors can be involved in plantar fasciitis and it is important not to look at it too reductively. After all the foot is just one small element of the lower limb and its gait cycle. However for most cases, movement is key.

Machine based pilates provides many opportunities to address plantar fasciitis. The footwork series that can be done on the reformer, cadillac or chair focuses on strength and flexibility in the foot and ankle. Emphasis is on taking these joints through their full range of motion in a number of different angles through varying levels of resistance. The springs of the Pilates machines provide elastic resistance ideal to restore the elasticity of the foot. However if the large Pilates equipment isn't available, exercises with Therabands can work very well too. Stability work is also useful here to restore resilience to the plantar fascia. Try standing on a wobble board or balancing on one foot for example. All in all essential qualities of a healthy foot are flexibility, stability, durability and balance. Whatever the means, by maintaining robust plantar fascia you will always ensure there is a spring in your step.

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