When most people think of scar tissue, they think of the scar that forms as a result of a surgical procedure. Scar tissue also forms as a result of a repetitive stress as in plantar fasciitis.
I have treated hundreds of cases of plantar fasciitis in my office and I make an effort to educate them on the underlying cause of the condition. I explain that scar tissue must be removed to gain any real progress. Many of them will question, what causes plantar fasciitis scar tissue?
Dr. Angela Walk
The Plantar Fasciitis Doc
Specializing in Foot & Gait Mechanics
What Causes Scar Tissue In The Feet?
Scar tissue is a collection of cells and collagen that covers the site of the injury. People can develop scar tissue as a result of an injury or from surgery. When a person has an injury, the body responds by repairing the damaged tissue by laying down these areas of scar tissue.
Scar tissue also forms as a result of a repetitive stress. It is also referred to as fascial adhesions, fascial restrictions, or simply “knots.” Think of scar tissue as the body’s duct tape.
For example, in the case of plantar fasciitis, if you walked too far in bad shoes, you overwhelmed the structural integrity of the plantar fascia and create small injuries also known as micro-trauma.
The body will lay down a quick "patch" to aid in healing these small injuries and that is known as scar tissue formation.
Unfortunately, over time, this scar tissue will build-up and accumulate and they start to affect the normal function of the muscles and fascia.
In fact, they will often lead to pain, tightness, lack of flexibility, muscle weakness, compromised muscle endurance, restricted joint motion, and diminished blood flow.
Every time you overwhelm the foot with a load that is greater than the capacity of the body's tissue to handle that load, the weaker patches become aggravated and lay down another layer of scar tissue.
You are left with plantar fascia tissue that is weaker than the original and more susceptible to future injury. At some point, many people have to pay the piper. This scar tissue MUST be removed. Rest, ice, stretching, and ibuprofen will not make them go away!
You may get some temporary relief, but once you resume your activities, the issue will make itself known once again. The best method to remove scar tissue is with specific soft tissue techniques.
How Do You Break Up Scar Tissue From Plantar Fasciitis?
Fascia is the connective tissue that wraps and surrounds every single thing inside of our body including the bottom of the foot.
When scar tissue is present in the fascia, as in plantar fasciitis, it causes restrictions and may feel like a giant knot in the bottom of your foot or calf muscle.
These fascial restriction and scar tissue MUST be removed before real healing can begin. It also MUST be removed and released before any progress with stretching can be achieved
The most effective way to remove scar tissue is with Instrument Assisted Soft Tissue Mobilization (IASTM). I have used IASTM in my practice for many years with great success.
The most well known and most effective types of IASTM methods for plantar fasciitis are Graston Technique and Gua Sha. I have extensive training in these techniques and have used both techniques with great success.
It involves the use of a stainless steel instrument or stone to "scrape" away scar tissue adhesions.
These tools greatly assist in soft tissue mobilization and improve blood flow to the affected area and in turn, release adhesions and scar tissue in the muscle tissue and create healing.
Many PF rehab protocols involve using a lacrosse ball, tennis ball, frozen bottle of water, or foam roller to release scar tissue and fascial adhesions, but these objects are just not as effective.
Does Graston Technique Work For Plantar Fasciitis?
If you’re an athlete or have an interest in sports, you may have heard of a treatment method called the Graston Technique. The Graston Technique is a soft tissue technique that uses a small stainless steal instrument to remove fascial adhesions and scar tissue from soft-tissue injuries.
It has been praised by many athletes and is gaining popularity outside of the world of sports as well due to it's ability to encourage the regeneration of healthy tissue and improve blood flow to an injured area.
The technique uses the instrument to locate and identify areas of restriction and hardened soft tissue. Pressure is applied with short and long strokes in all directions. The area will become red as the circulation/blood flow improves.
Only using the massage tool for 15-20 seconds on each area of tenderness before moving to the next "knot" or tender area is an effective approach. Scan the plantar fascia, gastroc (calf muscle), achilles tendon, and soleus muscles for scar tissue formation.
Find detailed instructions on using Graston technique on yourself here.
Can Gua Sha Help Plantar Fasciitis?
Gua Sha is a traditional Chinese healing technique that involves the application of pressure by scraping your skin with a massage tool or stone. It has continued to gain popularity due to it's effectiveness to alleviate musculoskeletal pain.
Gua sha (pronounced as gwahshah) comes from a Chinese word for scraping. Skin scraping, spooning, or coining are also the other known terms. This technique also involves applying pressure areas of restricted soft tissues.
It has a reputation of causing light bruising which may appear purple or red spots known as petechiae. As with other conventional Chinese medicine therapies, energy flowing through the body is qi or chi.
Many people believe that to ensure their health and well-being, a person’s qi must be balanced and freely flowing. It was believed that qi can be blocked causing muscle and joint pain or stress.
Gua sha uses a round edged tool to firmly stroke areas of tension, breaking up areas of congestion in the muscles and tendons. It effectively treats headaches, neck aches, persistent tension in the shoulders, back, and hips, and even plantar fasciitis.
Gua sha can break up and soften scar tissue making the scarred areas less painful and more functional. As with the Graston technique, expect some colorful results on the treated areas.
I have personally seen and experienced wonderful results with Gua sha in my chiropractic practice. Patients often feel immediate relief from stubborn pain and tension and it can play an important role in injury recovery.
Find detailed instructions on how to use gua sha for plantar fasciitis here.
Can I Treat Plantar Fasciitis At Home?
If you have this debilitating condition, here are my top 3 recommendations.
Because there is a so much misinformation out there about plantar fasciitis, I spend most of my time educating people on what NOT to do.
Most rehabilitation efforts fail because they are relying on cortisone shots, night splints, orthotics, ineffective stretching, thick, cushiony shoes, and rolling on a frozen water bottle.
These methods are either ineffective or just short-term band-aids, and do not provide long-term correction.
In my (6) step free guide, I offer solutions through addressing multiple factors. Improving footwear, identifying areas of weakness in the foot and ankle, and restoring proper foot function.
IASTM (Instrument Assisted Soft Tissue Mobilization) therapies offer many direct and indirect benefits. You can see pain reduction, improved flexibility, and improved circulation.
It can also act as a complement to your plantar fasciitis stretching protocols by further restoring range of motion.
Dealing with the pain of plantar fasciitis can be life changing--but it doesn’t have to be a life sentence.
By arming yourself with knowledge and taking charge of your healing, you can get back to the activities you love and feel like yourself again.
If you have additional questions about heel pain and plantar fasciitis, don’t hesitate to reach out. We’re here to help get you back on your feet--literally.
Best of Health,
I've written extensively on the topic of Plantar Fasciitis. Take a look at these other related blog posts:
Hi, I'm Dr. Angela Walk...
I have been involved in the health and wellness industry for over 20 years as a natural physician and sports chiropractor. I specialize in foot & gait mechanics and I have written extensively for many health publications.
I am keenly aware of trends and new developments in natural health and I embrace an active lifestyle combining diet, exercise and healthy choices.
My goal is to inform my readers of natural options available to them in hopes of improving their health and quality of life.
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