Plantar fasciitis

The plantar fascia is a connective tissue structure located on the sole of the foot that plays an important role in stability, load absorption, and adaptation during gait. 

It helps maintain the plantar arch and participates in how the foot responds to impact when walking, running, or standing for long periods. 

When this structure is subjected to more load than it can tolerate, pain can arise, particularly in the heel area or the sole of the foot. 

However, it is important to understand that the plantar fascia does not work in isolation.

The connection between foot, calves, knee, and hip 

The body functions as a chain where each area influences the next. 

The mobility and tension of upper structures can modify the way the foot receives loads. 

This chain involves: 

• Plantar fascia 

• Foot and ankle 

• Gastrocnemius and soleus (calves) 

• Popliteus

• Knee 

• Hip and pelvis 

Therefore, in some cases, treating only the sole of the foot may improve discomfort, but it does not always address the source of the overload. 

The role of the calves in plantar fasciitis 

The gastrocnemius and soleus muscles have a direct relationship with foot function. These muscles are part of the posterior compartment of the leg and participate in: 

• Propelling the body forward when walking or running 

• Controlling ankle movement 

• Absorbing forces during foot strike 

When there is tightness, overload, or poor mobility in this area, the tension transmitted to the Achilles tendon and the plantar fascia can increase. 

This can contribute to symptoms such as: 

• Heel pain 

• A sensation of tightness in the sole of the foot 

• Stiffness upon waking up in the morning 

• Discomfort after walking or standing for a long time

The popliteus: a small muscle that can go unnoticed 

The popliteus is a muscle located at the back of the knee that plays a role in the control and stability of this joint. 

It has key functions such as: 

• Helping to unlock the knee when initiating flexion

• Controlling tibial rotation 

• Contributing to stability during gait 

Although it is not usually the first muscle that comes to mind when foot pain appears, an impairment in its function can alter leg biomechanics and affect how loads are distributed to the ankle and plantar fascia. 

It is one of those areas that often go unnoticed because pain does not always present directly where the problem is located. 

Therapeutic approach in physiotherapy 

Treatment is tailored depending on the cause, but may include: 

• Myofascial release 

Targeting the plantar fascia, gastrocnemius, soleus, and related myofascial chains. 

• Deep dry needling 

When indicated, to treat muscular trigger points and overload. 

• Joint mobility and stability 

Focusing particularly on the ankle and structures that influence gait. 

• Therapeutic exercise 

To improve strength, stability, and tissue load-bearing capacity. 

• Invasive therapies: Techniques such as EPTE/percutaneous electrolysis 

When specifically indicated for targeted tissues.