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Plantar Fasciitis – Pain in the Arch

By Julie Donnelly, LMT

Pain in the arch of the foot will send both the sufferer and the physician on a wild–goose chase to find answers, frequently in the wrong direction! Often diagnosed as "plantar fasciitis", arch pain is a common symptom of tension in two muscles on the front and side of your lower leg, and may have nothing to do with the structures of the foot. Focusing attention on the foot is the reason that people try various types of therapies, drugs, orthotics, and medical providers, all without success.

A little understanding of anatomy helps explain the logic of this situation. You lift the front of your foot off the floor by contracting the two primary muscles of the front and outside of your lower leg. The two muscles, tibialis anterior and peroneals, both merge into tendons that insert into your arch. The tibialis anterior runs down the outside of your shinbone, crosses under a ligament at the front of your ankle, goes across the top of your foot and inserts into the arch, midway between your big toe and heel. When the tibialis anterior contracts normally it pulls up on this insertion point and the front of your foot raises, and it also pulls your foot a bit so you rest onto the outer edge of your foot.

The peroneals begin on the outside of your lower leg, just below your knee joint. It merges into the tendon just above your ankle and the tendon goes behind your ankle, under a ligament that is just underneath your ankle, and then goes into your arch. It attaches on the outside, and the inside, borders of your foot. When the peroneals contract normally you put pressure onto the inside of your foot (toward the big toe), while the outside of your foot raises off the floor.

A spasm, or "knot", in either of these two muscles will pull up on your foot, even when you are standing flat, causing a strain on the bones in your arch. You may wear out your shoes unequally, and be told you need to wear orthotics to bring the floor up to your foot. However, we always suggest you first try to release the tension in the muscles so your foot can move down toward the floor!

If you have ever sprained your ankle you will likely have a spasm in the peroneals and the tibias anterior muscles, potentially causing you problems for years until they are finally released. The reason is because as you twisted your ankle the muscles were overstretched, and then when you straightened your ankle they snapped back, but a spasm was created that will stay until it is physically released. We have seen people who have suffered with ankle and foot pain for years after twisting their ankle, and yet just a few minutes of working on the spasms in the peroneals and tibialis anterior eliminates the pain immediately.

Why These Two Muscles Cause Plantar Fasciitis

Since the two muscles contract every time you lift up the front of your foot, every step you take contracts the muscles. Ultimately muscle memory sets in, and the muscles shorten. Many people, for example those who do a lot of walking, running, or driving, experience pain along the shinbone, the ankle, and all of the bones of the foot, including the arch. This is discussed at length in our book The Pain–Free Triathlete, where you will also see pictures of the following treatment.

As either, or both, of these muscles pull on the insertion points on the arch, they actually will pull the bones out of alignment. This traps some of the nerves that are on the bottom of the foot between the bones, and also causes pain on the bone, just as pulling your hair will cause pain in your head.

Untying the knots is easy and will take the pressure off the insertion points. Sit down and press your opposite heel directly into the muscles, then push all the way down to your ankle. You will find tender points along the way, these are the spasms that are causing you pain. Keep the pressure on these points for about 30 seconds and then continue the pressure along the length of the muscle. Do this several times.

After you have released the tension in the tibialis anterior and the peroneals, then put your arch onto a ball (tennis, baseball, golfball) and roll your arch so the ball goes from the base of your toes to your heel. When you find the point that is especially tender, this is the insertion point that has been pulled out by the tight muscles.

You´ll be pleased when you see the results of this treatment. You may be able to eliminate the need to wear orthotics, and you´ll rid yourself of arch pain and plantar fasciitis!

© 2002

Julie Donnelly is a licensed massage therapist specializing in the treatment of chronic pain and sports injuries. She has co–authored several self–treatment books, including "The Pain–Free Triathlete" and "Carpal Tunnel Syndrome–What You Don´t Know CAN Hurt You." She teaches Julstro self–treatment workshops nationwide and is a frequent presenter at Conventions and Seminars. Julie may be contacted through her website: www.julstro.com.