“Various problems with the sacrum make up or contribute to a significant portion of lower back problems. Can understanding the anatomy and function help prevent and treat back injuries?”
The Sacrum
The sacrum is a bone shaped like an upside-down triangle located at the base of the spine that helps support the upper body when sitting or standing and provides pelvic girdle flexibility during childbirth. It comprises five vertebrae that fuse during adulthood and connect to the pelvis. This bone takes and endures all of the body’s pressure and stress from everyday activities and movements.
Formation
Humans are born with four to six sacral vertebrae. However, fusion does not take place in all sacral vertebrae simultaneously:
Fusion starts with the S1 and S2.
As the individual gets older, the overall shape of the sacrum begins to solidify, and the vertebrae fuse into a single structure.
The process usually starts in the mid-teens and finishes in the early to mid-twenties.
It is believed to start earlier in females than males.
The sacrum in a female is wider and shorter and has a more curved top or the pelvic inlet.
The male sacrum is longer, narrower, and flatter.
Structure
The sacrum is an irregular bone that makes up the back/posterior third of the pelvic girdle. There is a ridge across the front/anterior portion of the S1 vertebra known as the sacral promontory. Small holes/foramen on both sides of the sacrum are left over after the vertebrae fuse together. Depending on the number of vertebrae, there can be three to five foramen on each side, though there are usually four. (E. Nastoulis, et al., 2019)
Each anterior foramen is typically wider than the posterior or dorsal/backside foramen.
Each sacral foramina/plural of foramen provides a channel for the sacral nerves and blood vessels.
Small ridges develop between each of the fused vertebrae, known as transverse ridges or lines.
The top of the sacrum is called the base and is connected to the largest and lowest of the lumbar vertebrae – L5.
The bottom is connected to the tailbone/coccyx, known as the apex.
The sacral canal is hollow, runs from the base to the apex, and serves as a channel at the end of the spinal cord.
The sides of the sacrum connect to the right and left hip/iliac bones. The attachment point is the auricular surface.
Right behind the auricular surface is the sacral tuberosity, which serves as an attachment area for the ligaments that hold the pelvic girdle together.
Location
The sacrum is at the level of the lower back, just above the intergluteal cleft or where the buttocks split. The cleft starts at around the level of the tailbone or coccyx. The sacrum is curved forward and ends at the coccyx, with the curvature being more pronounced in females than males. It connects to the L5 lumbar vertebra by way of the lumbosacral joint. The disc between these two vertebrae is a common source of low back pain.
On either side of the lumbosacral joint are wing-like structures known as the sacral ala, which connect to the iliac bones and form the top of the sacroiliac joint.
These wings provide stability and strength for walking and standing.
Anatomical Variations
The most common anatomical variation applies to the number of vertebrae. The most common is five, but anomalies have been documented, including individuals with four or six sacral vertebrae. (E. Nastoulis, et al., 2019)
Other variations involve the sacrum’s surface and curvature, where the curvature differs widely between individuals.
In some cases, the first and second vertebrae do not fuse and remain separately articulated.
Failure of the canal to completely close during formation is a condition known as spina bifida.
Function
Studies on the sacrum are ongoing, but some proven functions include:
It serves as an anchor point for the spinal column to attach to the pelvis.
It provides stability for the body’s core.
It acts as a platform for the spinal column to rest on when sitting.
It facilitates childbirth, providing pelvic girdle flexibility.
It supports upper body weight when sitting or standing.
It provides extra stability for walking, balance, and mobility.
Conditions
The sacrum can be a main source or focal point for lower back pain. It is estimated that 28% of men and 31.6% of women aged 18 years or older have experienced low back pain in the past three months. (Centers for Disease Control and Prevention. 2020) Conditions that can cause sacrum pain symptoms include.
Sacroiliitis
This is a common condition of sacroiliac/SI joint inflammation.
A doctor only makes the diagnosis when all other possible causes of pain have been ruled out, known as a diagnosis of exclusion.
About half of all chordomas form in the sacrum, but the tumors can also develop elsewhere in the vertebral column or at the base of the skull. (National Library of Medicine. 2015)
Spina Bifida
Individuals can be born with conditions that affect the sacrum.
Spina bifida is a congenital condition that can arise from the malformation of the sacral canal.
Unlocking the Secrets of Inflammation
References
Gruss, L. T., & Schmitt, D. (2015). The evolution of the human pelvis: changing adaptations to bipedalism, obstetrics and thermoregulation. Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 370(1663), 20140063. doi.org/10.1098/rstb.2014.0063
Nastoulis, E., Karakasi, M. V., Pavlidis, P., Thomaidis, V., & Fiska, A. (2019). Anatomy and clinical significance of sacral variations: a systematic review. Folia morphologica, 78(4), 651–667. doi.org/10.5603/FM.a2019.0040
Barros, G., McGrath, L., & Gelfenbeyn, M. (2019). Sacroiliac Joint Dysfunction in Patients With Low Back Pain. Federal practitioner : for the health care professionals of the VA, DoD, and PHS, 36(8), 370–375.
Finger sprains and dislocations are common hand injuries that can happen during work, physical/sports activities, or in automobile collisions and accidents. Can recognizing the symptoms help in developing an effective treatment strategy?
Finger Sprains and Dislocations
Finger sprains and dislocations are common injuries of the hand that cause pain and swelling.
A sprain happens when the finger tissue that supports a joint gets stretched beyond its limits in a way that stresses the ligaments and tendons.
The ligament tissue can be partially or completely torn. If the damage is bad enough, the joint comes apart.
This is a dislocation – A dislocation happens when the joint in the finger gets shifted out of its normal position.
Both injuries can cause pain and stiffness in the finger and hand.
Sprains
Finger sprains can happen any time the finger bends in an awkward or unusual way. This can happen from falling on the hand or getting hurt when engaged in physical activities like sports or household chores. Sprains can occur in any of the knuckle joints in the finger. However, most commonly, the joint in the middle of the finger gets sprained. It’s known as the proximal interphalangeal or PIP joint. (John Elfar, Tobias Mann. 2013) Symptoms of a finger sprain can include:
Other treatments to help a sprained finger include:
Elevate the hand if swelling and inflamed.
Gentle finger exercises/movements to prevent stiffness.
Icing the injured finger.
Take an anti-inflammatory medication.
Individuals who have not broken bones or dislocated the joint will probably be able to move their finger in about a week. A doctor will set a timeline for when to start using the finger normally.
Individuals who sprain their finger that feels swollen and stiff for longer than a few weeks are recommended to consult a doctor or specialist.
Thumb sprains and finger sprains in children may need to be splinted or taped for longer periods, as the ligament is not fully developed or as strong, which could lead to a tear.
Dislocations
A finger dislocation is a more severe injury involving the ligament, joint capsule, cartilage, and other tissues that causes misalignment of the finger. The ligaments and the joint capsule get torn when a joint is dislocated. The joint needs to be reset, which can be a simple process, or in severe cases, patients may need to be placed under anesthesia or undergo surgery to reset the joint properly.
In these cases, tendons or other tissues might be preventing the joint from getting into position.
Putting the finger back into the right position is known as”reduction.” Once reduced, the finger needs to be splinted.
Individuals also need an X-ray to ensure the joint is lined up correctly and that any bones were not broken or fractured when they sustained the injury. (James R. Borchers, Thomas M. Best. 2012)
Once reset, caring for a dislocated finger is basically the same as a sprained finger. Using ice on the finger, keeping the hand elevated to reduce swelling.
Elfar, J., & Mann, T. (2013). Fracture-dislocations of the proximal interphalangeal joint. The Journal of the American Academy of Orthopaedic Surgeons, 21(2), 88–98. doi.org/10.5435/JAAOS-21-02-88
OrthoInfo from the American Academy of Orthopaedic Surgeons. (2022) Hand fractures.
Hung, C. Y., Varacallo, M., & Chang, K. V. (2023). Gamekeeper’s Thumb. In StatPearls. StatPearls Publishing.
OrthoInfo from the American Academy of Orthopaedic Surgeons. (2022) Finger fractures.
Borchers, J. R., & Best, T. M. (2012). Common finger fractures and dislocations. American family physician, 85(8), 805–810.
Individuals’ feet will heat up when walking or running; however, burning feet could be a symptom of medical conditions like athlete’s foot or a nerve injury or damage. Can awareness of these symptoms help identify solutions to relieve and heal the underlying condition?
Burning Feet
Walkers and runners often experience heat in their feet. This is natural from the increased circulation, heart rate, warm or hot sidewalks, and pavement. But the feet could experience an abnormal hot or burning sensation. Usually, the overheating is caused by socks and shoes and fatigue after a long workout. The first self-care steps include trying new or specialized footwear and workout adjustments. If burning feet persist or there are signs of infection, tingling, numbness, or pain, individuals should see their healthcare provider. (Mayo Clinic. 2018)
Footwear
The shoes and how they are worn may be the cause.
First, look at the material of the shoes. They could be shoes and/or insoles that don’t circulate air. They can get hot and sweaty without proper air circulation around the feet.
When choosing running shoes, consider a mesh material that allows airflow to keep the feet cool.
Consider getting fitted for shoes that are the right size, as the feet swell when running or walking.
If the shoes are too small, air can’t circulate, creating more friction between the foot and the shoe.
Shoes that are too large can also contribute to friction as the feet move around too much.
Insoles could also contribute.
Some insoles can make the feet hot, even if the shoes are breathable.
Swap the insoles from another pair of shoes to see if they are contributing, and if so, look into new insoles.
Tips to help prevent hot feet:
Topical Ointments
Use an anti-blister/chafing topical cream to lubricate and protect the feet.
This will reduce friction and prevent blisters.
Lace Properly
Individuals may be lacing the shoes too tight, constricting circulation, or irritating the nerves at the top of the foot.
Individuals should be able to slide one finger under the knot.
Remember that the feet will swell as walking or running commences
Individuals may need to loosen their laces after warming up.
Individuals are recommended to learn lacing techniques that will ensure they are not too tight over the sensitive areas.
Cushioning
Fatigue from long workouts or long days standing/moving can result in burning feet.
Individuals may need added cushioning in the shoes.
Look for work and athletic shoes that have added cushioning.
Shoe Allergies
Individuals may have an allergic reaction or a sensitivity to the fabric, adhesives, dyes, or other chemicals. (Cleveland Clinic. 2023) The chemicals used in production vary for leather compared to fabric and are different by brand and manufacturer.
A shoe material allergy may also result in burning, itching, and swelling.
It’s recommended to note whether symptoms only happen when wearing a specific pair of shoes.
Recommendations are to try different kinds and brands of shoes.
Socks
The sock fabric could be contributing to hot or burning feet. Steps to take can include:
Avoid cotton
Cotton is a natural fiber but is not recommended for walking and running as it holds sweat that can keep the feet wet.
It is recommended to use socks made of Cool-Max and other artificial fibers that wick sweat away and cool them down.
Wool
Wool socks can also cause itching and burning sensations.
Consider athletic socks made from itch-free wool.
Mindfulness
Individuals could be sensitive to other fabrics or dyes in socks.
Take note of which socks cause hot or burning feet symptoms.
Individuals could also be sensitive to laundry products and are recommended to try a different brand or type.
Medical Conditions
In addition to shoes and socks, medical conditions could cause and contribute to symptoms.
Athlete’s Foot
Athlete’s foot is a fungal infection.
Individuals may feel a burning sensation in the affected area.
Typically, it is itchy, red, scaling, or cracking.
Rotate shoes.
The fungus grows in damp places, therefore, it is recommended to rotate shoes to allow them to dry out between workouts.
Wash and dry the feet after walking or running.
Try home and over-the-counter solutions, powders, and remedies to treat athlete’s foot.
Peripheral Neuropathy
Individuals frequently experiencing burning feet apart from when they have been exercising could be due to nerve damage known as peripheral neuropathy. (National Institute of Neurological Disorders and Stroke. 2023) Peripheral neuropathy symptoms include pins and needles, numbness, tickling, tingling, and/or burning sensations.
Examination
Diabetes is one of the most common causes of peripheral neuropathy.
Diabetes can come on at any age.
Individuals need to learn how to protect their feet, as exercise is recommended for diabetes.
Other conditions that can produce peripheral neuropathy include:
Vitamin B-12 deficiency
Alcohol abuse
Circulatory disorders
AIDS
Heavy metal poisoning
Massage and Movement
Massaging the feet also increases circulation.
Exercise such as walking is recommended for peripheral neuropathy as it improves circulation to the feet.
Individuals suffering from hip, thigh, and/or groin pain could be experiencing iliopsoas syndrome. Could knowing the symptoms and causes help in diagnosis and treatment?
Iliopsoas Syndrome
Iliopsoas syndrome encompasses several conditions that affect the inner hip muscle and can cause hip and thigh pain. The muscle helps to bend the leg toward the body.
The condition is usually caused by overuse injuries and commonly affects individuals who perform repeated hip flexion movements, like cyclists, gymnasts, dancers, runners, and soccer players. (Liran Lifshitz, et al., 2020)
The term is often used interchangeably with psoas syndrome, iliopsoas tendonitis, snapping hip syndrome, and iliopsoas bursitis. However, there are clinical differences.
Hip or groin clicking or snapping that can be heard and/or felt during movement.
Pain and/or stiffness in the hip and thigh area.
Pain that worsens when bending the hip – walking, climbing stairs, squatting, sitting.
Movements that involve bringing the knee toward the chest can worsen the pain.
Causes
The iliopsoas muscles are hip muscles on the front of the hip. They are made up of the psoas major, the psoas minor, and the iliacus. Small, fluid-filled sacs/bursae are within the hip joint between bones and soft tissues. The bursae reduce friction and provide cushioning to help the tendons, muscles, and other structures move smoothly over the bony prominences.
Iliopsoas bursitis happens when the bursa, which is located between the iliopsoas tendon and the inside of the hip joint, becomes inflamed and irritated.
Iliopsoas tendonitis/hip tendonitis happens when the tendon that attaches the thigh bone to the iliopsoas muscle becomes inflamed and irritated.
Iliopsoas bursitis and tendonitis are commonly caused by overuse injuries and intense activities like cycling, running, rowing, or strength training.
Diagnosis
Healthcare providers can diagnose iliopsoas syndrome based on symptom history and a hip examination.
Imaging tests – MRI and X-rays may be used to rule out other injuries or conditions like muscle tears. (Paul Walker, et al., 2021)
Avoid putting weight on the hip for a few days after the injury.
Ice
Apply ice immediately after the injury to bring the swelling down.
Use a cold pack for 20 minutes at a time, several times a day.
Do not apply ice directly on the skin.
Compression
Wrap the area in a soft bandage or use compression shorts to prevent further swelling.
Elevation
Rest as often as possible with the leg raised higher than the heart.
Medical Treatment
Non-steroidal anti-inflammatory drugs like ibuprofen and naproxen sodium can alleviate pain and reduce inflammation. (Paul Walker, et al., 2021)
Steroid injections can be used if symptoms continue or come back with additional injections administered as necessary. (Paul Walker, et al., 2021)
After pain and swelling subside, physical therapy may be recommended, as well as mild exercises to gradually improve hip strength and flexibility. (Paul Walker, et al., 2021)
A healthcare provider may recommend surgery in severe cases where pain persists, and conservative treatments don’t provide enough relief.
Lifshitz, L., Bar Sela, S., Gal, N., Martin, R., & Fleitman Klar, M. (2020). Iliopsoas the Hidden Muscle: Anatomy, Diagnosis, and Treatment. Current sports medicine reports, 19(6), 235–243. doi.org/10.1249/JSR.0000000000000723
Walker, P., Ellis, E., Scofield, J., Kongchum, T., Sherman, W. F., & Kaye, A. D. (2021). Snapping Hip Syndrome: A Comprehensive Update. Orthopedic reviews, 13(2), 25088. doi.org/10.52965/001c.25088
American Association of Orthopedic Surgeons. OrthoInfo. Hip strains.
For individuals managing osteoarthritis, could massage therapy provide added treatment benefits?
Osteoarthritis Massage Therapy
Osteoarthritis happens when the cartilage between the joints wears away, causing stiffness and pain. Massage therapy is a treatment used to relieve various types of pain symptoms.
There are many types of massage therapy, that healthcare providers utilize to manipulate the muscles and other soft tissues to relieve symptoms, relax muscles, increase circulation, reduce inflammation, release trigger points, and restore mobility, flexibility, and function. (Ergonomic Trends. 2023)
Professional therapists can help relieve osteoarthritis joint pain by relaxing the surrounding muscles and other soft tissues to release stiffness. (Adam Perlman, et al., 2019)
Massage Objectives and Types
Massage therapists use their hands and fingers, forearms, elbows, and/or instruments to manipulate the body’s soft tissues. Soft tissues support and surround body structures and include muscle, fat, tendons, and ligaments.
The goal of osteoarthritis massage therapy is to relax muscles and soft tissues, increase blood and oxygen circulation, warm the affected area/s, relieve pain, and restore mobility and function.
Depending on the location of the muscles being massaged, individuals may be seated or lie down on a specialized table.
The amount of pressure and direction of movement depend on the body area.
Therapeutic oils and/or massage creams may be used to increase the therapy.
Types include:
Swedish
The therapist uses long strokes, kneading, and friction on the muscles.
Joints are moved to increase flexibility.
Deep Tissue
The therapist uses deep finger or instrument pressure, focusing on muscles that are tight or knotted.
Trigger Point
Trigger points represent a source of radiating pain symptoms.
The therapist focuses pressure on these myofascial tissue points using various strokes to release them.
Shiatsu
The therapist applies rhythmic pressure with their thumbs, fingers, and palms to redirect and increase energy or chi/qi.
A massage session lasts around 30–60 minutes depending on the severity of the condition and the number of sessions the patient has undergone. Chronic pain patients usually go through a series of specialized sessions that focus on specific areas and gradually build.
Risk Factors
Certain precautions must be taken before getting osteoarthritis massage therapy. Although there are a few serious risks, certain individuals are not suitable candidates and should not receive massage therapy. The conditions include: (Medical Massage Therapy Resource & Reference. 2023)
Damaged nerves.
Damaged blood vessels.
Infection and inflammation in the area to be massaged.
Open wounds.
Fever.
Taking a blood thinner.
Deep vein thrombosis – blood clots.
Bleeding disorders.
Osteoporosis – weak and brittle bones.
Recent fractures – broken bones.
Tumors.
Cancer.
Individuals who have recently undergone surgery.
Individuals with a skin condition that is contagious, like warts or herpes, or noncontagious, like psoriasis, could be aggravated by touch or pressure.
Individuals who have cancer, fragile skin, heart problems, or dermatomyositis are recommended to discuss osteoarthritis massage therapy with their healthcare provider.
Research on the effects of massage therapy on various health conditions is ongoing. Massage therapy promotes relaxation while reducing stress, which can help with chronic joint issues like osteoarthritis.
Perlman, A., Fogerite, S. G., Glass, O., Bechard, E., Ali, A., Njike, V. Y., Pieper, C., Dmitrieva, N. O., Luciano, A., Rosenberger, L., Keever, T., Milak, C., Finkelstein, E. A., Mahon, G., Campanile, G., Cotter, A., & Katz, D. L. (2019). Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial. Journal of general internal medicine, 34(3), 379–386. doi.org/10.1007/s11606-018-4763-5
For individuals with digestive and other health issues, could resistant starch provide health benefits?
Resistant Starch
Typical starchy foods are simple starches that are rapidly digested. This sends their sugars into the bloodstream, contributing to weight gain and increasing the risk of diabetes and heart disease. (Erik E. J. G. Aller, et al., 2011) Resistant starch is a food component that is a type resistant to digestion. This means that it passes into the large intestine and interacts with the gut flora. Foods that contain resistant starch pass through the stomach and small intestine without being absorbed. In the large intestine, they are fermented by the gut bacteria which releases substances that are beneficial to health.
Health Benefits
Studies on the health benefits are ongoing. Scientists are researching how it can help with weight management and colon health:
Weight Management
Research is beginning to show indications that foods with resistant starch can help with weight loss and the ability to help offset the diseases associated with weight gain that include: (Janine A. Higgins. 2014)
High cholesterol
Diabetes
Metabolic syndrome
Cardiovascular disease
Colon Health
In addition, researchers are finding preliminary evidence indicating that resistant starch might possibly help with: (Diane F. Birt, et al., 2013)
A prebiotic that encourages a healthy balance of gut flora.
Inflammatory bowel disease symptom improvement.
Prevention of colon cancer.
Protection against diverticulitis.
However, more research is needed.
Consumption Amount
Estimates on how much should be consumed range from a minimum of 6 grams to a maximum of 30 grams. It is estimated that most individuals consume less than 5 grams per day, (Mary M. Murphy, et al., 2008). As individuals increase their intake, it is recommended to do so slowly, to minimize unwanted gas and bloating.
Bananas
Bananas are a healthy source of resistant starch.
They have the maximum amount when they are unripe.
The resistant starch content reduces as the banana ripens.
If green/unripe bananas are not appealing, making a smoothie can help with the taste.
Potatoes
Potatoes have their highest level of resistant starch when raw.
However, individuals can maximize their intake by allowing the potatoes to cool before eating.
Rice
Levels of resistant starch depend on whether the rice is white or brown.
Similar to potatoes, intake can be maximized from rice by allowing the rice to cool.
Oats
Cooking oats in water, as most are accustomed to making oatmeal, diminishes the resistant starch content.
Rolled or steel-cut oats are recommended as dependable sources of resistant starch.
Chickpeas
Chickpeas, also known as garbanzo beans, are nutritional powerhouses.
They are a healthy source of dietary fiber, along with many vitamins and minerals, and resistant starch.
Cooked and/or canned chickpeas contain high levels of resistant starch.
They go with salads or as a side dish or snack.
For individuals with IBS, well-rinsed canned chickpeas are considered to be low in FODMAPs or carbohydrates that can contribute to symptoms. (Anamaria Cozma-Petruţ, et al., 2017)
It is recommended to keep the serving size to a 1/4 cup.
Lentils
Lentils serve as a healthy source of plant-based protein.
Cooked they can provide resistant starch.
They can be prepared in soups or side dishes.
From a can, they can be IBS-friendly by being well-rinsed and limited to a 1/2 cup serving.
Bread
Various breads offer varying levels of resistant starch.
Pumpernickel bread contains high levels.
Breadsticks and pizza crusts have high levels.
Individuals with IBS may be reactive to the FODMAP fructan or the gluten protein.
Other recommended high-resistant starch options are corn tortillas or artisanal sourdough bread that is traditionally prepared.
Green Peas
Green peas, even when cooked, are a healthy source of resistant starch.
They can be prepared in soups or as a side dish.
However, green peas have been found to be high in the FODMAP GOS and could be problematic for individuals with IBS. (Anamaria Cozma-Petruţ, et al., 2017)
Beans
Most types of cooked and/or canned beans are recommended sources of resistant starch.
The highest levels are found in white and kidney beans.
They can be served in soups, as a side dish, or mixed with rice.
Beans are a high-FODMAP food and could contribute to digestive symptoms in individuals with IBS.
Body In Balance: Chiropractic Fitness and Nutrition
References
Aller, E. E., Abete, I., Astrup, A., Martinez, J. A., & van Baak, M. A. (2011). Starches, sugars and obesity. Nutrients, 3(3), 341–369. doi.org/10.3390/nu3030341
Higgins J. A. (2014). Resistant starch and energy balance: impact on weight loss and maintenance. Critical reviews in food science and nutrition, 54(9), 1158–1166. doi.org/10.1080/10408398.2011.629352
Birt, D. F., Boylston, T., Hendrich, S., Jane, J. L., Hollis, J., Li, L., McClelland, J., Moore, S., Phillips, G. J., Rowling, M., Schalinske, K., Scott, M. P., & Whitley, E. M. (2013). Resistant starch: promise for improving human health. Advances in nutrition (Bethesda, Md.), 4(6), 587–601. doi.org/10.3945/an.113.004325
Murphy, M. M., Douglass, J. S., & Birkett, A. (2008). Resistant starch intakes in the United States. Journal of the American Dietetic Association, 108(1), 67–78. doi.org/10.1016/j.jada.2007.10.012
Cozma-Petruţ, A., Loghin, F., Miere, D., & Dumitraşcu, D. L. (2017). Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients!. World journal of gastroenterology, 23(21), 3771–3783. doi.org/10.3748/wjg.v23.i21.3771
Individuals with plantar fasciitis may experience consistent flare-ups. Can knowing the causes help to find pain relief?
Plantar Fasciitis Flare-Up
Plantar fasciitis is a common cause of heel and foot pain. The plantar fascia is a band of tissue that runs along the bottom of the foot and becomes inflamed. Certain factors can cause plantar fasciitis flare-ups, including:
Increased levels of physical activity.
Not stretching regularly.
Wearing shoes without proper support.
Weight gain.
Causes
A plantar fasciitis flare-up is often triggered by physical activity. (MedlinePlus. U.S. National Library of Medicine. 2022) It can also be brought on by underlying conditions, like increased body weight, arthritis, or the shape of the foot. (Johns Hopkins Medicine. 2023) Despite the root cause, there are activities and experiences that can contribute to and/or worsen the condition.
New Exercise Routine
Being highly physically active can exacerbate plantar fasciitis symptoms.
High heels, boots, or shoes that raise the heel above the toes.
Worn-out shoes like exercise workout shoes.
Not Stretching Properly or At All
Tight calves can increase pressure on the plantar fascia.
Stretching the calves, Achilles tendon/heel, and the bottom of the feet is highly recommended to help treat and prevent the condition. (Johns Hopkins Medicine. 2023)
Not stretching thoroughly or skipping stretches can worsen symptoms.
Individuals with plantar fasciitis are recommended to stretch before and after physical activities, exercise, before going to bed, and after waking up.
Working Through the Pain
Individuals may try to continue physical activities during a flare-up.
This is not recommended as doing so can cause more pain and worsen the condition.
When pain presents, it’s recommended to:
Stop all activities that strain the feet
Stay off the feet for at least a week.
Tearing the Plantar Fascia
The plantar fascia rarely tear completely from repeated stress known as a plantar fascia rupture.
Pascoe, S. C., & Mazzola, T. J. (2016). Acute Medial Plantar Fascia Tear. The Journal of orthopaedic and sports physical therapy, 46(6), 495. doi.org/10.2519/jospt.2016.0409
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