Why I Don't Promote Plantar Fascia Stretching- (Part 2)

Click here to see what we discussed in Part 1.

The science backing plantar fascial stretching (PFS) is not convincing to say the least. So, how about a little common sense if you're not convinced yet. Let’s make the isolated gastrocnemius contracture and calf stretching sexy, what do you say?

First, let’s examine the act of PFS. It is not easy to do and requires one to be barefoot and sitting. Awkward! Yet, calf stretching is so easy to do: anywhere, anytime, and done with your shoes on.

Pure collagenous structures like the plantar fascia and the Achilles tendon really don’t stretch much, if any. Let me be even more clear, they don’t stretch unless we use a knife.  Certainly they do not “move” compared to muscle and it’s surrounding weaker, less substantial connective/collagenous tissue. Spending ones time stretching the plantar fascia is like moving a mountain. But I digress. The plantar fascia is not even the problem, so even if one could stretch it, why do it?

Here are two repeatable and simple daily occurrences that show the plantar fascia being tight is not the problem, thus PFS is misguided.

"So much of what we do everyday is habit based on what we saw someone do or what we were told to do."

1. Why does wearing higher heels (yes, I said higher, not high) like Dansko’s or mild wedges, so often give temporary relief? 

Go ahead, be honest, release your guilt and admit that these type shoes feel better. I know that you have been categorically told to never wear those shoes and wear flats/supportive shoes, but that does not make it right. So much of what we do everyday is habit based on what we saw someone do or what we were told to do. But could this ‘any heel is bad’ concept be wrong? Damn right it could be. Go ahead and wear those higher heels if you want, they just might make you feel better. Dudes, you can wear cowboy boots. One would think that the windlass effect in the foot would place the plantar fascia under an acute, increased tensile strain and incite immediate pain, not relief, with the use of any heel.

This would happen because the toes are dorsiflexed (raised up), which places more tension on the plantar fascia. Look it up! What higher heels actually do is immediately relax the gastrocnemius a bit, which in turn reduces the linked tension on the plantar fascia. If someone has a better explanation, bring it.

2. Have you ever noticed the diagrams of the foot and the tearing and the inflammatory "fire" representing plantar fasciitis. They always show the heel up in the air near toe-off when the toes are dorsiflexed and the plantar fascia is under maximal strain or tension. OUCH! See! It’s so obvious, yet so utterly wrong., LOOK IT UP!

This is where misperception and urban myth run amuck. The plantar fasciitis pain experienced during walking gait is not when your heel strikes the ground and it is definitely not after the heel raises and the toes roll up as you toe-off. The pain is always experienced at a precise time in the gait cycle giving the characteristic shortened gait of plantar fasciitis, as well as many other problems that result from an isolated gastrocnemius contracture. It is the brief time just before the heel raises, not after. This is because the gastrocnemius reaches its length limit and runs out of room and the stride is shortened to subconsciously avoid the pain produced as the plantar fascia comes under intense tension over a very short time. This is also why going downstairs and walking uphill is routinely more difficult: these activities require more ankle dorsiflexion.

The evidence abounds and is growing everyday as to the association between the isolated gastrocnemius contracture/equinus and plantar fasciitis as well as many other foot and ankle problems. Why do we (doctors, patients, physical therapists. trainers, etc.) categorically deny what is right there in front of us? The literature is finally catching up to this fact. Just sit back and watch over the next 5-10 years as the powerful, damaging effects that the isolated gastrocnemius contracture exerts upon the human foot and ankle becomes common knowledge.  Who knows, calf stretching might even rise to sexy status.

Keep moving, my friends,

AO

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