Massage can be an important part of treatment for plantar fasciitis. This condition typically has symptoms that include foot, especially heel, pain that is worse first thing in the morning, after sitting or standing for a long time, and at the beginning of a sporting activity.
The plantar fascia is a broad band of tissue on the bottom of the foot that starts at the heel and runs to the ball of the foot. Plantar fasciitis has often been thought of as a condition caused by chronic inflammation but recent research suggests the condition is due more to the breakdown of collagen in the tissue (often following an episode of inflammation). Collagen is a protein essential to supporting body tissues.
Some sources distinguish between plantar fasciitis, inflammation caused by initial microtears in the fascia, and plantar fasciosis, continuing pain after initial inflammation subsides and the collagen begins to break down.
Here's what happens. Microtears occur in the fascia either because of direct injury or, more commonly, repeated trauma, such as running, sitting at a desk with your heels off the floor for long periods of time, or standing all day, especially on a hard surface. Poorly fitting shoes, especially those with narrow toe boxes, contribute to the problem.
The first symptom of this foot injury is usually dull, intermittent pain in the heel, often eventually becoming a sharp, persistent pain not only in the heel but also mid-sole or near the toes.
If there's a lot of damage to the plantar fascia, heel spurs (excess bone growth) can develop. Sometimes, plantar fasciitis is called heel spur syndrome, although the spurs don't cause the initial pain but are another symptom of the problem.
Because the foot is difficult to rest, the problem gradually becomes worse. The fascia gets tighter and tighter, and adhesions and scar tissue form. Massage can be part of the treatment for plantar fasciitis by releasing tension in the foot and surrounding muscles and breaking up the adhesions/scar tissue.
If you have been diagnosed by your doctor as having plantar fasciitis, feel free to give a copy of these instructions to treat plantar fasciitis to your massage therapist.
Important Note to Massage Therapist: Make sure to use a stretch and pressure well within the pain tolerance level of each client. This problem didn't occur overnight and time is required to lengthen the muscles and restore the muscle memory. Too much stretch can cause excruciating pain, which defeats the whole purpose of the massage because the pain causes the muscle and fascia to tighten up even more.
Repeat this massage procedure at least once a week (twice can produce much faster results, if it's not too much for the client's foot). Although this procedure uses pin and stretch techniques, another option is longitudinal stripping methods and cautiously applied transverse friction - for more information, see this article in in Massage Magazine by orthopedic massage therapist Whitney Lowe.