Plantar Fasciitis

woods plantar 300x225 Plantar Fasciitis

Plantar Fasciitis is a condition which presents as pain anywhere along the band of tissue (plantar fascia) which runs between the heel and toes, along the sole of the foot.

 

What Is The Function Of The Plantar Fascia
The plantar fascia, a thick band of connective tissue which runs along the inner aspect of the sole of the foot, serves to support the inner arch of the foot, by taking up tension upon weightbearing through the foot. In this way, the plantar aponeurosis acts almost like a shock absorber in the foot.

When walking, the aponeurosis also acts like a spring, which lengthens & recoils depending on the position of the foot and the phase of the gait cycle is being undertaken.

The planter fascia also plays an important role in the “Windlass Mechanism” of the foot when walking or running, whereby lifting of the toes leads to a tightening of the plantar fascia, thereby giving a more stable foot off which to push oneself forward.

What Causes Plantar Fasciitis?
Research has evolved in recent years, to generally contradict the longstanding belief that plantar fasciitis was predominantly due to an underlying inflammatory process within the plantar tissue.

Current research has shown the condition to primarily be one of gradual tissue degeneration, often associated with long standing weakening or “over load” of the implicated planter tissues.

Associated research has also shown there to be weakening of the small, localised muscles in the foot in runners experiencing chronic plantar fasciitis.

What Are The Risk Factors For Plantar Fasciitis?

  • Obesity or being overweight (particularly in the non-athletic population) has been associated with plantar fasciitis
  • Heel spurs (bony prominence on the back of the heel) have also been shown to be present in many sufferers of plantar fasciitis
  • Reduced flexibility of the calf muscles has been shown to place increased strain on the fascia
  • Over-pronation (loss of inner foot arch) has also been proposed as a risk factor
  • Age, tendency to stand for prolonged periods, and loss of mobility of the toes and/or ankle joint have also been identified as possible predisposing factors

How Does Plantar Fasciitis Present?
Several typical factors are reported by those experiencing plantar fasciitis;

  • Pain being at its worst upon the first few steps in the morning
  • Pain on the first few steps having been sat for a prolonged period
  • Pain can move anywhere up & down the sole of the foot, from the heel to just below the toes

How Can Physiotherapy Help
Many physiotherapy treatments have been shown to be successful in their treatment of plantar fasciitis. Treatment is tailored to suit the individual symptom presentation of the patient, following a thorough initial assessment. Treatment may include

  • Transverse friction massage
  • Acupuncture
  • Taping
  • Fascial manual therapy
  • Strengthening & eccentric strengthening
  • Advice on activity modification

What Can I Do To Help This Condition Myself?
Prior to, or while attending physiotherapy, the patient can also help the recovery process by following several steps to address both cause and symptoms of the sore foot

  • Applying a cold compress (bag of ice wrapped in a tea towel) to the painful site, for approximately 5 minutes, several times daily This will serve to reduce pain-inducing swelling
  • Avoid undertaking any activities which involve repetitive loading of the sole of the foot – this will reduce the stress placed on the implicated band of tissue, thereby reducing the on-going mechanical irritation, & giving the tissues a chance to heal. Such a modification can simply involve not being on the feet for long enough at any given time to exacerbate symptoms.
  • Undertake gentle “self massage” to the underside of the foot, where the primary point of pain is located. This can involve simply placing a golf ball etc. under the foot, & gently rolling the tender point(s) on the ball. This will serve to desensitize the pain receptors in the involved tissues, and to reduced localised soft tissue tightness
  • Stretching and strengthening the calf muscles on the painful side can also reduce the stresses on the plantar fascia, thereby again giving it a chance to recover.