Plantar fasciitis, the flip flop disease

September arrives and the pain in the sole of the foot begins, and when you go to the doctor he tells you about the "flip flop disease" or, technically, of the Plantar fasciitis.

Obviously, the misuse or abuse of flip flops is not the only cause that can cause plantar fasciitis, but physiotherapists can affirm that many of these injuries would be avoided if the use of flip flops were limited and they were not used continuously.

But what is plantar fasciitis? Plantar fasciitis is a inflammation of the Plantar fascia (o plantar aponeurosis) that covers the sole of the foot.

Plantar fascia injuries are very painful and disabling for a runner for being support in the race; if also the corredor or the corredIf you tend to have a cavus foot and a valgus ankle, you are more likely to end up suffering from the dreaded plantar fasciitis with improper use of flip flops.

Plantar fasciitis, a very common injury after the summer

Plantar fasciitis is an injury very common in physiotherapists' offices after the summer period.

When summer arrives, there is a logical change in footwear and we go from closed footwear to more open footwear, which does not support the entire foot and the problem can arise when the use of footwear such as flip flops is abused.

This is because when we wear flip flops, the center gravity is usually later freeing the first toes (the first and fifth meta), generating an attraction on the back of the foot, on the calcaneus that will tighten the fascia with each step we take, especially in toe flip-flops (like the hawaiian).

Due to this posteriority of the center of gravity, we will lose mobility in the ankle, generating a tendinopathy associated with the Achilles tendon, an overload of the calves that will pull on the calcaneus, generating more tension on the sole of the foot and creating a deficit in the buffer function.

Plantar fasciitis can make daily activities difficult

Plantar fasciitis is a pathology that should not be confused with posterior tibial nerve entrapment and Baxter nerve entrapment, which gives pain in the plantar fascia, confusing neural entrapment with a problem of plantar fasciitis.

You have to be very exhaustive and precise in the assessment to correctly treat the injury that really exists. In the case of neural entrapment, we must release the neuropathy to relieve pain, but this is not directly related to the lesion in the plantar structure.

If there is plantar fasciitis, that is, a real lesion in the plantar fascia, we have to give you a solution as soon as possible.

We are facing a setback that should not be underestimated because it can cause pain that makes daily activities difficult (we are not just talking about running anymore). And the great risk faced by those who do not quickly address the problem of plantar fasciitis is that to avoid the pain it produces, they end up changing the way they walk and that this ends up causing additional problems in the ankle, knee, hip or back.

The problem with this pathology is that it is a poorly vascularized structure, highly innervated and, in addition, it is where the weight of the body rests during the march, acting as a natural shock absorber in each stride we make.

The plantar fascia is a structure designed to cushion the impact and thus be able to distribute the loads during the race; It is a structure that will suffer in long-distance races (a marathon, for example) where the impact is always the same and will suffer less in short-distance races or where the impact is adapted to each step, such as in a trail.

An injured fascia should measure approximately 40mm when an ultrasound is performed, and thus study whether the fascia is intact or damaged to differentiate whether it is tendinitis (inflammation) or tendinosis (degeneration) in both cases treatment by your trusted physiotherapist is mandatory and necessary.

It must be taken into account that an injury to the plantar fascia has a cure time of more or less 1 year Due to the fact that it is a little vascularized structure and therefore all the physiotherapy that can be applied to the tissue to improve the blood supply will improve the treatment and the decision of the plantar fascia.

Tips for using flip flops in summer

So, is the use of flip flops prohibited during the summer period? The answer, obviously, is no; the use of flip flops is not prohibited, but it is convenient to follow a series of recommendations to correctly choose the right flip flop to avoid the possibility of an injury as disabling as plantar fasciitis.

My advice for a correct choice of flip flops are the following:

1. It must be comfortable.
2. Preferably with an anterior inclination.
3. Avoiding flip-flops that set the first goal and condition on the foot.
4. Choice of bridge flip flop, comfortable, soft and cushioning.
5. Alternate flip flops with walking barefoot.
6. Do compensatory ankle mobility and calf and soleus stretches.
7. Alternate the use of flip flops with slippers; what should not be done is to wear flip flops continuously.

Recommendations to recover from plantar fasciitis

As to home treatment to be done to help the physiotherapy treatment so that the structure heals and the biomechanics of the leg help to improve, my recommendations are the following:

1. Apply heat to the sole area of ​​the foot to improve vascularization
2. Treat with Foam Roller, the gastrocnemius and soleus to remove tension in heel traction.
3. Walking barefoot on different floors to educate the fascia to the pressure of the ground
4. Avoid using flip flops.
5. Avoid heels and platashapes.
6. Perform foot muscle strengthening exercises, explained and directed by your physiotherapist.

As we have indicated in other posts The best way to avoid suffering any injury is to prevent it.; Once the injury has occurred, it is extremely important to put yourself in the hands of a physiotherapy professional as soon as possible to work on the structural part of the injury while continuing to practice sports and be able to continue training to find the sporting objectives that you have set for yourself.

Other articles by physical therapist David Valenzuela, from Box 55.

If you are interested in other content related to injury prevention by physiotherapist David Valenzuela, you can find different articles on our blog that may be of interest to you.

For example, if you want to know how to prevent tendinopathy, you can find information in the article Tendinopathy, a 'hell' of injury. You can also find out how to prevent low back pain or meniscus injuries with the articles Low back pain, the good weather injury y How to prevent meniscus injuries.

If you are a mountain runner and you are interested in knowing how to prevent ankle sprains, you can read the article 3 golden rules to prevent ankle sprains on the trail running.

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David Valenzuela Diaz

Physiotherapist at BOX55

David Valenzuela Díaz has a degree in physiotherapy from the Cardenal Herrera CEU University and a Master's degree in assessment, physiotherapy and sports rehabilitation from the University of Valencia. He is CEO of BOX55 Fisioterapia y Academia SL, of BOX55 Academy and of Valobando SL Functional Biomechanical Analysis.
David Valenzuela, CEO of BOX55

Other entries by David Valenzuela Díaz

• The functional bandage, the runner's lifesaver
• Hamstring tear, injury to fear
• How to prevent meniscus injuries