Plantar fasciitis is an inflammatory condition of the thick fibrous plantar fascia. In chronic conditions, the tugging of the plantar fascia at its point of origin causes a calcaneal heel spur.
Patients will typically complain of pain at the heel for the first few steps after prolonged rest. Deep aching pain can also be felt in the area of the medial arch following weightbearing activities.
The Windlass Mechanism describes the plantar fascia’s reaction to a flattened medial arch. When the truss arch structure (formed by the calcaneus, mid-tarsal joint and metatarsals) collapses, the plantar fascia is described as the tie-rod that attempts to ‘right’ the arch.
The term ‘windlass’ refers to a tightening of rope-like structure and describes the attempt of the plantar fascia to prevent or correct arch collapse by tightening and pulling the origin and insertion points closer together.
In reality, the tensile strength of the plantar fascia is not enough to repel the ground reaction forces coming upward and the body weight force coming downward, forcing the arch collapse. But the plantar fascia will not accept defeat and continues to contract and pull on the attachment points.
Time allows for chronic spasm of the plantar fascia, inflammation at the origin and insertion points, and repetitive stress at the medial tubercle of the calcaneus. The calcaneus then succumbs to Wolff’s Law and begins laying bone and forming a heel spur.
It is typically around this time in the progression of the condition that the patient shows up for treatment.
Treatment programs for the condition normally involve stretching and strengthening exercises such as wall stretches or stair stretches. These are recommended to correct the weakness of the foot muscles and to increase the flexibility of the calf muscles.
A comprehensive active rehabilitation program for plantar fasciitis will include postural correction of the foot as well to relieve stress on the plantar fascia and restore functional kinematics.
By reintroducing a proper medial arch to the foot throughout all phases of gait, the windlass effect of the plantar fascia can return to its intended action of bracing the foot in supination and allowing functional pronation.
MASS4D® foot orthotics will provide the support needed for the foot to achieve its corrected posture and allow for healthy biomechanics of the foot.