Seems that every year at this time I hear from students complaining about a new pain that has developed on the sole of the foot near the heel. When I question them further, there is almost always a history of a recent increase in high-impact activity, like starting to train for a running race, or starting new dance classes. On rare occasions, they may have just started a yoga boot camp where they are doing a lot of jump backs from Uttanasana to Chaturanga, or from Down Dog to Forward Fold. I often suggest they get it checked out by their doctor, and invariably they come back with the diagnosis of plantar fasciitis, more commonly called “heel spurs.” An -itis implies inflammation, and in this case, the plantar fascia, the sheet of connective tissue that stretches from the heel to the base of the toes, is inflamed.
The plantar fascia assists the ligaments and the muscles in maintaining the arches at the sole of the foot. As connective tissue, it has strength, but does not stretch much before running the risk of tearing or becoming inflamed. And, unlike muscles, it does not contract and create active movement in the foot.
You are more likely to get plantar fasciitis if you have problems with your arches, such as flat feet or unusually high arches or a tight Achilles tendon. Sudden weight gain or obesity can also be contributing factors. And, as stated above, long-distance running, especially running downhill or on uneven surfaces, or any new and continued activity that puts unusually strain on this sheet of tissue, can cause inflammation. Even wearing shoes with poor arch support or soft soles can be problematic.
People with plantar fasciitis feel stiffness and pain on the sole of the foot near the heel. It can be dull or sharp, worse on the first few steps out of bed in the morning, better with continued movement if is not super flared, and recurs if you have been sitting for a while and get up and walk again. It can also occur if you are standing for long periods or climbing stairs, or after intense activity. One of my students whose plantar fasciitis is improving notices some lingering pain when the affected foot is back in Warrior I Pose. We are modifying it for now by using a wedge under that heel.
Unfortunately there’s no quick fix for plantar fasciitis. In fact, it can take from two months to two years for this condition to resolve. A typical orthopedic treatment plan could include, ice, resting by not doing aggravating activities, anti-inflammatory medication, wearing an immobilizing splint at night, and physical therapy stretches for the Achilles tendon and feet. The use of orthotics, steroid shots, and surgery are used in more resistant cases.
What’s a yogi to do? Well, resting poses, such as Legs up the Wall (Viparita Karani) and all the inversions that involve having your feet in the air will take pressure off the plantar fascia. And poses that stretch the Achilles tendon and the feet, if done with mindfulness, so as to avoid aggravating your foot symptoms, can help. Almost all of the standing poses could have possible benefits in this regard, and Garland Pose (Malasana), could do double duty.
The opposite case could be made if the style of yoga or particular pose are aggravating to the foot (such as jump backs). In those cases, you may need to do some creative propping to continue to practice without worsening your symptoms. Doubling up your sticky mat for more cushioning can help, as can using a wedge under the ball of the front foot or heel of the back foot to minimize stretch on the plantar fascia. An example of a pose that puts a lot of pressure onto the front foot heel is Parsvottanasana (Intense Side Stretch or Pyramid Pose). Here I would use the wedge under the ball of the front foot. As always, if you want yoga to be in the mix of a healing plan for your feet, work with a teacher with experience around plantar fasciitis for the greatest chance of success.