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The excessive and repetitive strain placed upon certain connective tissues during weightbearing (eg the Plantar Fascia), can lead to a kind of fraying or micro-tearing of them, causing inflammation, pain, and potentially degeneration to occur. This strain is amplified and exacerbated by one game-changing factor which the human foot is neither “designed” for or well suited to: the vast majority of the surfaces we stand, walk and run on are extremely dense and hard, and unnaturally and uniformly flat/smooth, (e.g. concrete, tiles, floorboards, even carpet has hard flat flooring underneath it!).
Footwear definitely helps to counter the negative effects of constantly bearing our weight on these surfaces, and if everybody walked barefoot all the time, there would be significantly more heel pain than there currently is. However, footwear alone is often not sufficient to prevent heel pain from arising, and up to 15% of us will experience Plantar Fasciitis at least once in our lives, a figure that has risen steadily over the last few decades.
The insidious effect these modern-day surfaces have on our feet eventually take their toll. The hardness/density dramatically increases the ground reaction force “pushing up” into the foot during weight bearing (standing, walking, running). This acts to lower and elongate the arch (essentially overpronation - the foot rolling inwards too much). The uniform flatness of these surfaces (in combination with the hardness) then creates a repetitive strain on structures such as the Plantar Fascia - a wide ligament like band that runs nearly the entire length of the bottom of the foot. In the above diagram the mechanism of the bow and the string gives us a clear picture of how this occurs, whereby the Plantar Fascia is represented by the bowstring and the arch of the the foot the bow. This repetitive strain ultimately leads to micro-tearing or even actual tears in the fascial fibres (Plantar Fasciitis). It also exerts a torsional (twisting) repetitive strain on the Achilles Tendon, leading to Achilles issues and creating and exacerbating the symptoms of Severs Disease. The very cause of these disorders therefore (this repetitive strain), then also prevents or decreases the chance of healing, and a vicious cycle is created.
As well as this repetitive strain on these tissues, the constant weight bearing on these surfaces also leads to a profound weakening of many of the muscles of the foot and lower limb, as they don't have to work nearly as strenuously as they do on more natural, uneven surfaces. This weakening of these muscles combined with the previously mentioned strain on the connective tissues can lead to a gradual and permanent increase of overpronation (rolling in or flattening of the foot) which over the years can then cause permanent structural changes to occur in the foot (eg: bunions, flattening of the arch).
These hard, flat, modern-day surfaces are, however, extremely practical and convenient, and unavoidable anyway. The important thing to realise is that in order to successfully treat Plantar Fasciitis and other heel pain, it is imperative to attempt to counteract the negative effects of these surfaces as much as possible (using various means), thereby ensuring the best chance of complete healing and a permanently pain free heel.
At Heal My Heel we do just that!