Some Considerations on Plantar Fasciitis
I had plantar fasciitis and tried to play with it. It slowly got worse over about a year. I did not see a doctor. I read that tendons and similar tissues take 3-6 months to heal. I finally took off from tennis for 3 months. The PF went away. A friend of mine had a similar experience and took off for a year.
Along the way, I read about many of the other subjects mentioned in this thread.
I tend to read and then make up a story that makes sense to me. I have been very wrong before so check out any of my opinions independently. ……..one mistake could be a show stopper……..
The term “plantar fascia” as used here means all muscles, tendons, fascia, etc, on the bottom of the foot – This structure has not been clearly defined in what I have read.
As discussed on the websites one main cause of plantar fasciitis is tight & short calf muscles. The calves connect to the heel through the Achilles and the heel connects to the plantar fascia - all in one chain. There are two calf muscles, the gastrocnemius and the soleus. Both the gastrocnemius and soleus connect through the same tendon to the heel, the Achilles (also another potential injury spot if the calves are tight).
Bent Knee or Straight Knee? An important point is that the gastrocnemius connects to the bone above the knee. When the knee is semi-straight the gastrocnemius contributes a lot of force but as soon as the knee is bent a little the gastrocnemius becomes slack and contributes much less force. The soleus is connected below the knee and can apply force through the heel whether the knee is straight or bent. Only the soleus works when seated.
During Tennis Gastrocnemius or Soleus? During tennis which of the two calf muscles is causing the most strain on the Achilles and plantar fascia? I don’t know and have not seen it discussed. On one hand maybe some very stressful straight-leg move such as changing direction while coming down might be the most damaging. ? On the other hand it seems that tennis is being played mostly with a bent knee. Therefore it seems reasonable that the soleus might be the muscle most often causing too much strain on the plantar fascia. ?
Life Style. Most people spend a great deal of time with the calf in a much shortened state: sitting at the computer with bent knees and pointed toes (pointed toes = short calf muscles), watching TV with pointed toes, sleeping with pointed toes, etc. Sitting around, sleeping, etc. for 120 hours a week and then playing tennis for 8 hours a week sets up the problem. If the calves have become too short or tight during tennis they overstretch the plantar fascia and put excess strain on it.
Strengthening Exercises. Exercise both calf muscles with straight leg calf raises. Exercise only the soleus with seated calf raises.
General Stretching. 1) I have read that you should warm up the muscle before stretching. That is easy to do for calves, run a little or do calf raises on steps. 2) Also, that you should not stretch when injured……….this is problematic for most tennis players because they don’t want to quit………..?
Calf stretching – There are straight knee stretches for both gastrocnemius and soleus. There are bent knee stretches for just the soleus. My favorite bent knee soleus stretch is - while seated - to place a thick telephone book under the front of my foot, heel off the floor, cross the other leg over for a little added weight and do a gentle stretch. After a warm up, this stretch is easy to do while watching TV.
If you only do straight knee stretches and the gastrocnemius is tight does the soleus get a useful stretch?
Night Issues- You play tennis and afterward the PF hurts more or less. You go to bed and point your toes for some hours. During sleep healing occurs. The calves and plantar fascia are in a shortened state. You wake up and get out of bed, ouch! I speculate that your tight calves are tearing up some of the new healing of a short plantar fascia. ?? Help, Doc. (Mine would hurt for a minute or two just in front of my heel.) Night splints stretch both your calf and the plantar fascia so that any healing is done with the plantar is more elongated.
