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PLANTAR FASCIITIS AND WOMENS HORMONES

Updated: Oct 20


As a Pilates teacher I see a myriad of different client needs each week. One thing that has me particularly interested over the past while is Plantar fasciitis (PLAN-tur fas-e-I-tis) one of the most common causes of heel pain.


Why so fascinating? The majority of clients that I see dealing with this are Women that have gone through the hormonal changes of menopause; and experiencing heel and or foot pain on varying levels, from chronic flare ups to light heel pain when getting out of bed in the morning.


It got me thinking back to a Women’s Health course (*Support the Floor) that I had completed through *The Centre for Women’s Fitness and the discussion about the loss of oestrogen directly impacting the laxity throughout the female body. In this particular instance it was in relation to the pelvis, which all lower extremity muscle fibre either directly or indirectly connects to.


The plantar fascia serves as an elastic cushion for weight applied to the foot and also helps increase stability in the ankle. It is a thick fibrous connective tissue that originates at the heel and inserts at each of the 5 toes. Research has shown that:


“Women have significantly higher rates of anterior cruciate ligament (ACL) injuries and anterior knee pain than men. Previous studies have shown that ACL injuries are associated with changes in anterior and posterior cruciate ligament laxity due to changes in body temperature during the menstrual cycle and the effect of beta estrogen receptors on these two ligaments. Investigations into the effect of estrogen on the knee ligaments and the Achilles tendon raise questions about how the ligaments in the foot, such as the plantar fascia, might be altered during the menstrual cycle. It stands to reason that, if these same estrogen receptors are found in the plantar fascia, the ligament will be most flexible at ovulation.”

In laymen’s terms, our hormones influence collagen and elasticity within the ligaments of the body throughout stages of the menstrual cycle and menopause. Ovulation is the point when these ligaments are at their softest and most pliable. Therefore, when women move in to and then through menopause, or have had a Hysterectomy, which places the body in to early menopause, the laxity associated with the hormones is no longer there.


We may begin to feel ‘rigid and tight’ in the lumbo pelvic region. We tend to lose those fat pads from under our muscle tissue that helps to give our muscle form (*important to keep up resistance training) and as this happens our shape changes, our posture changes, the muscle we lose our bums; our biggest pelvic stabilizers. The synergy between quadriceps and hamstrings is interrupted and we can perhaps tend more towards a quad dominant movement pattern with short tight hamstrings and zero glute muscle = imbalance.


So what has that got to do with sore feet?

Imagine you walking around all day on the balls of your feet. I am sure many of us have and wear raised heel shoes and feel that ‘tightness’ under the foot once we remove those shoes. That shortening and tightening of the plantar fascia can cause inflammation leading to varied levels of pain or chronic plantar fasciitis and even tears in the fascia.


What can we do? and I say we because I am at the precipice of menopause myself

· Controlled resistance training, like Pilates. Either floor or equipment based. To build up and maintain glute muscles and strengthening the pelvic and hip muscles. A very simple exercise that can be done at home is Bridging with so many wonderful variations and benefits for the whole body. See our blog about Bridging.


· Calf stretches and fascia release using a roller or even massaging your calves throughout the day. Our calves are very often forgotten and have such an important role to play with lymphatic drainage of the lower extremities. They are often called “The Second Heart” of the body. The body is engineered so that when you walk, the calf muscles pump venous blood back toward your heart.


· Toe stretches. As easy as it sounds.


· Sensible foot-ware (now I know I am getting older saying that) and going bare foot.


· Foot strengthening and mobilization exercises (did I say Pilates is great for this).


As with anything exercise related, we recommend checking with your medical practitioner as to the suitability of any exercise program for your body.


References

Lower Extremity Review Magazine

Associates for Women’s Medicine

The Centre for Women’s Fitness

Jerrold Petrofsky, PhD, JD; and Haneul Lee, PT, DSc

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