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Can planar fascia be stretched?

Posted by Ric on 4/10/98 at 13:27 (000559)

I am seeing a podiatrist for severe arch pain in my foot, which he says is due to an inflammed planar fascia. He told me that I need to stretch, and I got a device (prostretch) to do so. But all of the stretches he tells me to do are basically stretching either my calf or my achilles tendon. My question is whether it is possible to stretch out the planar fascia. My podiatrist tells me the planar fascia is ligament, and not tendon. But I have had surgery on other parts of my body to tighten up ligaments that have become very long as a result of sudden falls. So if the planar fascia is a ligament, is it possible that a quick overextension of some sort would stretch it way out, and then it would be long enough that it wouldn't be irritated as I walk? I tried to stretch the planar fascia gradually, by using a night splint with a rolled up washcloth under my toes, to keep them as far up as they would go. This only seemed to irritate the planar fascia (and was uncomfortable after a few hours). Perhaps I should have started more gradually, but without the toe lifts the night splint didn't seem to do anything. In theory, it seems as if stretching the planar fascia ligament would be the solution to all of my problems. I'd really appreciate any insight others might have on this. Right now I don't know whether to continue trying to stretch my planar fascia, or to try to think of some other cure. Thanks very much--I'm desperate.

Re: Can planar fascia be stretched?

Karl on 4/12/98 at 01:28 (000569)

Whether you call it a ligament or tendon, my research over the past year has led me to some conclusions. First, the point where the (lets call it a ligament) attaches to the heel bone is usually where the problem begins. The ligament isn't detaching completely away from the heel bone, but it is fraying (It would take alot to completely severe the ligament). This is what I understand to be the pain, the fraying (Example: you could have a crack on your lip from the cold, but that doesn't mean it will continue to crack up your face). As the PF tries to heal we place weight on it and it frays again and again. Scar tissue builds up and makes it even more difficult heal because it is like a tight knot. In order to treat this, I found it necessary to message the are to break up scar tissue and stretch the area. The idea is to gain back the flexibility that that was present before the injury. Don't stretch in jerking motions, otherwise you'll reinjure the area. I think curing PF is personal trial and error and what works best for you. This message area has alot of ideas that may work for some, and not for others. For me, I think message, stretching, magnisium, calcium, and warm weather are going to be beneficial. If not, I'll continue searching for a combination that works. Try different treatments yourself to determine which is best for you.

Good Luck

Re: Can planar fascia be stretched?

jill on 4/13/98 at 22:38 (000578)

my doctor initially made me a plaster cast to use as a night splint that carefully molded to my feet and then pushed the toes up. it turned out to be too intense a stretch and tore my heel out. She now has made me another out of a soft fiberglass with less intense stretch but pushing the toes up. she said to start up for short times. I agree that the regular night splint boot dosn't seem to do it. I am still confused as to whether stretching the plantar is really the key because it often has irritated my foot more.

Re: Can planar fascia be stretched?

Douglas Padian on 4/16/98 at 18:29 (000590)

My impression is that stretching of the plantar fascia itself is not as effective as stretching of the calf muscles and the achilles tendon. The theory is that that the plantar fascia is tight because the achilles tendon is too tight. The plantar fascia is a ligament ( not a tendon ) because it attaches bone to bone -- your toes to your heel. However, there is a part of it that attaches to the achilles tendon. If the achilles tendon is too tight, it pulls on the plantar fascia and makes it too tight. Thus it can't handle the constant pounding of the foot all day and gets inflamed.

Since the achilles tendon attaches to the soleus and gastronemeus muscles that make up the calf, doctors tell us to stretch those muscles. Muscle has the capacity for elongation much more than tendon or ligament does, so that is where one would get the most efficacy. So if the calf is tight, the achilles tendon is tight, and the plantar fascia is tight. If the calf is loose, in theory the rest of this system is loose. Of course, this is all theory because I've stretched like crazy and it doesn't seem to work for me. But I used to do a plantar fascia stretch for a long time and that didn't seem to do much for me.

Night splints ( as I understand them ) are also more for stretching out the calf and achilles tendon than the plantar fascia, although the plantar fascia also gets stretched. I keep running into trouble reinjuring my fascia with these stretches. I was using the prostretch for a few weeks and getting a really good stretch, but I overdid it and my feet felt like they were burning for a few days so I had to stop til it subsided. What a pain. Anyhow, I hope this helps.