Plantar Fasciitis
What is Plantar Fasciitis?
Plantar fasciitis is a fairly common foot condition which is felt in the heel. The plantar fascia is usually the source of the pain. The plantar fascia is a thick band of tissue that connects the heel bone to the toes and supports the arch of the foot. When the plantar fascia becomes irritated it can lead to discomfort and difficulty with weight-bearing activities.
The hallmark symptom of plantar fasciitis is pain in the heel, typically felt on the underside of the foot. The pain is often described as sharp, stabbing, or aching, and it is usually most intense with the first few steps in the morning or after periods of rest.
The exact cause of plantar fasciitis is still not 100% clear but it is now known that inflammation is not the main cause of plantar fasciitis so actually plantar heel pain is probably a better name for this condition.
Both sedentary people or very fit active runners can get plantar heel pain but it is thought to occur when there is an increased load placed on the plantar fascia.
We know that there are certain factors that can contribute to the development of heel pain. Activities like running, a patient’s biomechanics, or their weight are some of things that can play a part in plantar heel pain.
What are the Causes of Plantar Fasciitis?
Overload or a sudden increase in activity. Activities that involve repetitive stress on the foot, such as running, jumping, or standing for prolonged periods, can load the plantar fascia and cause discomfort.
Foot mechanics, such as high arches (pes cavus) or flat feet (pes planus), can increase the stress on the plantar fascia, making it more prone to injury. These conditions can result in improper distribution of weight and altered foot alignment during walking or running.
Tight muscles. Tightness in the calf muscles can limit ankle mobility and increase the strain on the plantar fascia. The Achilles tendon blends into the plantar fascia so if it is tight it places greater stress on the fascia.
High BMI. Excess weight places additional stress on the feet, including the plantar fascia, increasing the risk of developing plantar fasciitis.
Age and gender: Plantar fasciitis commonly occurs between the ages of 40 and 60. Women are more likely to experience the condition, possibly due to hormonal factors which we are currently learning much more about recently.
Occupational factors: some occupations that involve prolonged periods of standing or walking on hard surfaces.
What is the Treatment for Plantar Fasciitis?
Treatment for plantar fasciitis aims to reduce pain, promote healing, and improve function.
Education and advice - understanding your problem will empower you to start the journey to getting better. Understanding the condition, including its causes, expected duration, and self-management strategies. Advice around activity modification may also be beneficial in the early stages. Graded exposure to daily tasks is often the most effective treatment and will be discussed in detail at your first appointment.
Strengthening exercises. Strengthening exercises aims to increase the tensile strength of the calf and plantar fascia. This should increase the tissues ability to cope with load going through them and therefore reduce pain. There are also benefits to improving strength and control in other areas such as the knee and the hip.
Stretching exercises: Regular stretching exercises that target the calf muscles and plantar fascia can help reduce pain and stiffness. Regular stretching can aid in the recovery process and prevent recurrences.
Footwear modification: Wearing supportive shoes with good support, cushioning, and shock absorption can help reduce strain on the plantar fascia. Also choosing shoes appropriate for the intended activity are also important. Orthoses or gel heel wedges can often help distribute pressure more evenly and reduce strain on the plantar fascia.