Plantar Fasciitis is Caused by Shoes
Plantar fasciitis is caused by shoes. In populations that do not wear shoes, plantar fasciitis does not usually exist. Shoes impose a few problems that directly cause plantar fasciitis:
I have been thinking about this problem a lot, and have been trying to think of ways to implement minimal footwear/barefoot walking into plantar fasciitis treatment. The problem with this approach is that many people who already have severe plantar fasciitis will develop more pain from wearing minimal footwear/walking barefoot. Wearing supportive shoes and insoles does help the problem for now, but at the same time, it is causing the problem. How should we fix this?
Progressively. Over time, you want to wear less supportive shoes so that your plantar fasciitis can be fixed for good. If your pain is on and off, and comes back every few months, you need to strengthen you feet so that they can support themselves. This is the only way to fix the pain for good. (learn about what shoes I recommend for this progression by clicking here)
Toe spreading products can put your foot bones into their natural position so that your muscles are not excessively stretched or shortened. They also increase blood flow to the foots muscles. They also promote mobilization in areas of the foot that need to expand/contract and flex/extend. You need the foot moving so that it can absorb shock. (click here to see my favorite toe spreading devices)
The other component that you need is a minimal footwear shoe (when the pain has subsided). These shoes will promote proper foot motion because they have:
This may sound crazy because you are so dependent on your supportive shoes and orthotics to keep the plantar fasciitis pain at bay. What you need to do is find shoes that are less supportive while the pain decreases. You always want to challenge the foot with less support, till you do not need it at all, and the foot can support itself.
Keep in mind that this does not mean to just walk around barefoot! Barefoot walking can help some people who have plantar fasciitis, but for most people, it can make the pain worse. Slowly and progressively make this change in footwear! If you have been wearing orthotics and arch support for years, your first goal is to progress to walking pain free without your arch support. Get some toe spreaders and work on this daily.
- Shoes cause the bones of the foot to be in a dysfunctional position (narrow and tapered toe boxes cause the toes and other bones of the foot to be smashed together), which causes the arteries and nerves that run between the bones, to be compressed. This causes a lack of nutrient and waste exchange, which is the perfect environment for degenerative processes to develop (such as plantar fasciitis).
- Shoes (and orthotics) hold the bones in a static position. If the foot cannot move how it is made to move, then it will be unable to absorb shock. The shock will have to go somewhere else in the body. This can cause foot/knee/lower back problems.
- Shoes push the big toe towards the other toes, causing bunions. If you have a bunion, or a mild bunion, then the muscle that supports your arch, the abductor hallucis muscle (which connects the heel bone to the big toe) will be held in a stretched position. When this muscle is held in a stretched position, the plantar fascia's blood supply (which runs next to the abductor hallucis muscle) is compromised. If you do not have adequate blood flow to the plantar fascia, it becomes degenerative. It becomes dead tissue. The abductor hallucis is also needed for supporting the arch of the foot.
- Shoes with cushion absorption properties cause the foot to pronate excessively. This causes further strain to the plantar fascia. This also causes the ankles to go inward, which will set you up for knee/hip/back pain later down the road. Also remember that there are people in this world that walk all day long on concrete without any pain. The reason why is that they are barefoot! Your body can absorb the shock on its own.
- Shoes with motion control inhibit the muscles of the foot from doing their job of stabilizing the foot. If you support the foot or make its job easier, then it will become weak.
- Shoes lift the big toe and other toes upward. This is very easy to see in high heels or running shoes. If you keep the toes in this position, the muscles that connect to them, which are the flexors of the foot, will be forced into a stretched position. When muscles are in a chronically stretched position, they are inherently weak. These muscles, the flexors of the foot, need to be strong so that the arches of the foot are supported. The reason that the muscles on the bottom of your foot are filled with trigger points is because they are trying to shorten themselves (because they have been excessively stretched for so long). Remember that trigger points are a chronic contraction of muscle in response to being chronically stretched. You need to shorten these muscles by wearing shoes that have a flat sole.
- Another problem with shoes today is that the heel is lifted. If your shoe causes your heel to be higher than the ball of your foot, you are asking for plantar fasciitis to develop (most shoes have at least a 1 inch rise).This is a problem because this shortens the calf muscle. Why are your calfs so tight and tender? Because they are adapting to the position that your shoes are putting them in. Keep in mind that when a muscle is chronically shortened or lengthened, it is weak. Your foot flexors are being over stretched, and your calf muscles are being excessively shortened, from wearing shoes.
I have been thinking about this problem a lot, and have been trying to think of ways to implement minimal footwear/barefoot walking into plantar fasciitis treatment. The problem with this approach is that many people who already have severe plantar fasciitis will develop more pain from wearing minimal footwear/walking barefoot. Wearing supportive shoes and insoles does help the problem for now, but at the same time, it is causing the problem. How should we fix this?
Progressively. Over time, you want to wear less supportive shoes so that your plantar fasciitis can be fixed for good. If your pain is on and off, and comes back every few months, you need to strengthen you feet so that they can support themselves. This is the only way to fix the pain for good. (learn about what shoes I recommend for this progression by clicking here)
Toe spreading products can put your foot bones into their natural position so that your muscles are not excessively stretched or shortened. They also increase blood flow to the foots muscles. They also promote mobilization in areas of the foot that need to expand/contract and flex/extend. You need the foot moving so that it can absorb shock. (click here to see my favorite toe spreading devices)
The other component that you need is a minimal footwear shoe (when the pain has subsided). These shoes will promote proper foot motion because they have:
- Big and wide toe box so that your toes can move in every direction, and splay outward (fixing bunions and toe crowding)
- Zero heel drop. Your heel needs to be at the same height as the ball of your foot, and your toes. The sole of the foot should be flat.This will fix the calf tightness and foot flexor issues.
- Flexible sole. You should be able to bend the shoe in half at any location on the sole.
- No cushion, no arch support.
This may sound crazy because you are so dependent on your supportive shoes and orthotics to keep the plantar fasciitis pain at bay. What you need to do is find shoes that are less supportive while the pain decreases. You always want to challenge the foot with less support, till you do not need it at all, and the foot can support itself.
Keep in mind that this does not mean to just walk around barefoot! Barefoot walking can help some people who have plantar fasciitis, but for most people, it can make the pain worse. Slowly and progressively make this change in footwear! If you have been wearing orthotics and arch support for years, your first goal is to progress to walking pain free without your arch support. Get some toe spreaders and work on this daily.