In lieu of jumping to injections or surgery for treatment, plantar fasciitis massage is becoming more recognized as effective first-line intervention.
Plantar fascia is the thick fascia running the entire length of the bottom of the foot- from the heel to the base of the toes – and functions as a shock absorber for the arches of the foot. In walking, the heel makes contact with the ground and rolls through to the toes. For this reason, how well one is able to walk/move functionally is directly related to the tone of the plantar fascia. Plantar fasciitis occurs when the plantar fascia has come under too much repetitive strain, causing inflammation and at times tears in the tissue. Soft tissue in this condition frequently tightens up, weakens, and becomes less functional. With plantar fasciitis, this, in turn, causes pain in the sole of the foot, most classically worse in the morning and when also coming onto the toes of the affected foot.
Common causes of plantar fasciitis can include a sudden increase in long distance running or working out, poor support in footwear, walking or standing for long periods of time on hard surfaces and being overweight.
Does massage help plantar fasciitis?
Because massage therapy directly treats soft tissue (which includes muscle, fascia, tendons, ligaments), it can be of great help in treating plantar fasciitis. Additionally, plantar fasciitis is frequently correlated to very tight muscles in the calves and feet, as these regions of our body have been compensating for whatever precarious position we’ve been placing our moving feet in.
Research has shown massage to outshine other methods of treatment, particularly deep tissue massage:
DMS=deep massage therapy to posterior calf muscles and neural mobilization with a self-stretch exercise program
USS=common treatment protocol of ultrasound therapy to the painful heel area with the same self-stretch exercises
FS= Functional status (FS) at admission and discharge from therapy as measured by the Foot & Ankle Computerized Adaptive Test was the main outcome measure
“The basic premise for introducing deep massage treatment to the calf was that contraction of the ankle plantar flexor muscle group generated heel pain. The DMS treatment targeted to calf muscles demonstrated a greater improvement in functional abili- ties compared to ultrasound treatment directed to the heel pain area. The USS group achieved a statistically significant change in the FS score of 6 points at the end of treatment; however, this was not clinically significant as it did not reach the MCIC of 8 points. Whereas the change in the FS score of 15 points in the DMS treatment group was significant both statistically and clinically.”
Deep tissue massage for plantar fasciitis
As noted above, research has shown massage to be an effective treatment for plantar fasciitis, particularly deep tissue massage. Deep tissue massage, as a technique, involves deeper, specific pressure either along the length of or across the fibers of the muscles described above. Deep tissue massage works well for plantar fasciitis, because it can break up the adhesions created by the strain and overuse of repetitive activities such as too much running. It also loosens muscle tension and restores proper blood and oxygen circulation in the muscles, which improves function. Soreness for a day or two can be a result of this kind of massage, but the muscles should feel much better than they did before the massage once this soreness dissipates.
Open wounds and blood clots are a very strong CONTRAINDICATION to Deep Tissue massage for plantar fasciitis.
Calf massage for plantar fasciitis
The calf and foot muscles are intimately related in makeup and function. Not only are our feet powered by the muscles in our calves, but the fascial makeup of each are interconnected if not one in the same. For example the most superficial calf muscle, know as the Gastrocnemius, has fascia that extends into and makes up the tissue of the Achilles heel, which then extends into and becomes the plantar fascia on the sole of the foot. For these reasons, proper treatment of plantar fasciitis must include calf massage; i.e. massage of the following muscles:
- Gastrocnemius- As noted, these are the most superficial calf muscles, the bodies of which you can easily see when the foot is flexed (plantar flexion). Plantar flexion, an action of the Gastrocnemius, occurs when we press the ball of our foot and toes into the ground. This muscle crosses the knee joint, which allows it to also bend the knee, and extends toward the heel. When this muscle is strained- bending the knee will decrease the pain.
- Soleus- This muscle is deep to the Gastrocnemius and is known as the “power house” of the calf muscles. Its length runs from just under the knee to the heel and also flexes the foot. We would fall over while standing if we didn’t have the Soleus muscle due to its part in continuously holding us upright. Also, this muscle is very important in venous return- that is, pumping heart from our low limbs back towards the heart. When this muscle is strained, whether the knee is bent or not, there will be pain.
- Deep flexors- These group of muscles run deep to the Soleus and are accessed via the inside of the low leg along the shin bone. They help to flex the foot as well.
- Generally speaking, holistic massage addresses not only the muscles in pain but also related muscles. This can include muscles that work together to do the same actions, opposite actions, or supportive actions. With this in mind, two additional muscles to consider addressing while treating plantar fasciitis, include the Tibialis Anterior located along the front of the shin bone and the Peroneals located along the outside of the calf. These muscles are deeply related to the function of the arches of the foot.
Plantar fasciitis self massage
Massage will always only be part of your overall treatment plan because it enhances your capability for change; however if this capacity is not reinforced in daily life, real change can be hindered. With this in mind, it is important to do self care. Self-care for plantar fasciitis can include:
- Stretches for the legs, calves, ankles, and feet;
- Rest, i.e. desisting the aggravating activity and switching to low impact exercise
- Applying ice or heat for pain and/or control of inflammation
- Kinesiotaping- Watch this video to learn how to apply your own tape to support your foot:
- Wearing more supportive footwear
- Strengthening the structure of the foot, which includes the base of the foot and lower leg- working with a personal instructor who has a strong knowledge of anatomy, function, and rebalancing muscles is ideal