Calf tightness maybe the cause for plantar fasciitis

Plantar fasciitis is reportedly the most common cause of pain in the inferior heel in the adult population (Buchbinder, 2004), and also one of the most common conditions in runner (Lopes et al., 2012) who will eventually present to their Osteopath, Physiotherapist or GP practice and most will improve over the year with conservative treatment (Thomas et al., 2010). these conservative treatments consist of progressive plantar fascia and intrinsic foot muscle stretching techniques have been shown to reduce plantar fasciitis pain (Hyland et al., 2006).

Before we go any further lets break down the anatomy to help. The Gastrocnemius runs to the Achilles tendon from two heads attached to the femur. The achilles attaches to heel (Calcaneus), and the plantar fascia attaches to the another end of the heel. Therefore, if the gastrocnemius pulls on heel, this could put tension on the plantar fascia. This constant stretching of the plantar fascia results in microtears, collagen disarray and granulation tissue due to the repetitive stress associated with standing upright and weight bearing, which results in primarily a degenerative process (Buchanan & Kushner, 2021). This gastrocnemius tightness has been long associated with plantar fasciitis (DiGiovanni et al., 2002; Patel & DiGiovanni, 2011), Although, it is unknown to the extent it influences plantar fasciitis (Pearce et al., 2021), as the hamstring muscle group has an association with Plantar fasciitis (Labovitz & Kim, 2011), however we will save this for another blog post.

Pearce et al,. (2021) study found that gastrocnemius tightness had a significant influence on plantar fasciitis, and they used a protocol called “Alfredson’s eccentric stretching regime” which helped the majority of the population (P=33) in the study over the 9 month period. Therefore, if you are dealing with plantar fasciitis this could be part of your routine to help with your issue.

Reference

Buchanan BK, Kushner D. Plantar Fasciitis. [Updated 2022 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431073/

Buchbinder R. (2004). Clinical practice. Plantar fasciitis. The New England journal of medicine, 350(21), 2159–2166. https://doi.org/10.1056/NEJMcp032745

DiGiovanni, C. W., Kuo, R., Tejwani, N., Price, R., Hansen, S. T., Jr, Cziernecki, J., & Sangeorzan, B. J. (2002). Isolated gastrocnemius tightness. The Journal of bone and joint surgery. American volume, 84(6), 962–970. https://doi.org/10.2106/00004623-200206000-00010

Hyland, M. R., Webber-Gaffney, A., Cohen, L., & Lichtman, P. T. (2006). Randomized controlled trial of calcaneal taping, sham taping, and plantar fascia stretching for the short-term management of plantar heel pain. The Journal of orthopaedic and sports physical therapy, 36(6), 364–371. https://doi.org/10.2519/jospt.2006.2078

Labovitz, J. M., Yu, J., & Kim, C. (2011). The role of hamstring tightness in plantar fasciitis. Foot & ankle specialist, 4(3), 141–144. https://doi.org/10.1177/1938640010397341

Lopes, A. D., Hespanhol Júnior, L. C., Yeung, S. S., & Costa, L. O. (2012). What are the main running-related musculoskeletal injuries? A Systematic Review. Sports medicine (Auckland, N.Z.), 42(10), 891–905. https://doi.org/10.1007/BF03262301

Patel, A., & DiGiovanni, B. (2011). Association between plantar fasciitis and isolated contracture of the gastrocnemius. Foot & ankle international, 32(1), 5–8. https://doi.org/10.3113/FAI.2011.0005

Pearce, C. J., Seow, D., & Lau, B. P. (2021). Correlation Between Gastrocnemius Tightness and Heel Pain Severity in Plantar Fasciitis. Foot & ankle international, 42(1), 76–82. https://doi.org/10.1177/1071100720955144

Thomas, J. L., Christensen, J. C., Kravitz, S. R., Mendicino, R. W., Schuberth, J. M., Vanore, J. V., Weil, L. S., Sr, Zlotoff, H. J., Bouché, R., Baker, J., & American College of Foot and Ankle Surgeons heel pain committee (2010). The diagnosis and treatment of heel pain: a clinical practice guideline-revision 2010. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 49(3 Suppl), S1–S19. https://doi.org/10.1053/j.jfas.2010.01.001