Plantar fasciitis is one of the most common complaints from runners that come in for sports massage. They may only experience a mild discomfort in the heel first thing in the morning, and others may have moderate to severe pain on a regular basis. The name sounds quite menacing, and for some runners it can be, but essentially “plantar fasciitis” just means that the fascia on the bottom of the foot is inflamed.
Common “treatments” for plantar fasciitis include rolling a golf ball or frozen bottle of water under the foot, wearing shoe inserts, and foam rolling. These common approaches may provide pain relief in the moment but often do little to provide a long-term treatment for plantar fasciitis. Quite often the actual problem is not with the plantar fascia itself, but with the soleus and gastrocnemius muscles in the calf. These muscles, along with the plantaris, come together to form the achilles tendon which attaches at the heel and then continues around the bottom of the foot creating the plantar aponeurosis (fascia).
So what does all this anatomy mumbo-jumbo mean in laymen’s terms?
Excessive and chronic tension in these calf muscles is often transferred down the leg and into the foot, aggravating the heel and plantar fascia. This persistent tension combined with the physical demand of running can cause the inflammation runners are experiencing as heel and foot pain. (This is often the case with other forms of tendonitis as well. Golfer’s elbow and tennis elbow are two classic examples. Chronic tension in the muscles of the forearm are irritating the corresponding tendons and causing inflammation.)
So what treatment for plantar fasciitis does work?
In our experience, thorough decompression of the muscles and fascia in the calf is the best place to start for lasting pain relief from plantar fasciitis. Massaging the heel and foot can feel great in the moment and is certainly recommended, but the real therapeutic value of sports massage for runners takes place farther up the kinetic chain in the gastroc/soleus complex. Relieve the tension in the calf and, by proxy, the heel and foot should open up as well. In more complex situations, the chronic tension in the calf muscles may be originating from other imbalances in the body. In these cases, structural bodywork can can be used to help treat more systemic problems.