How To Treat Plantar Fasciitis
What is Plantar Fasciitis?
Plantar Fasciitis is the most common reason of rear foot pain and is caused by aggravation of the plantar fascia. The plantar fascia is a broad, thick band of tissue that runs from the heel and attaches under the toes. This band is needed to maintain the medial arch of the foot and to provide shock absorption during walking.
Plantar fasciitis was traditionally thought to be an in ammatory condition. This is now believed to be incorrect due to the absence of in ammatory cells. In reality it is caused by degeneration of the collagen fibres within the plant fascia.
Plantar fasciitis causes
The most common causes of plantar fasciitis is tightness of lower limb myofascial structures (calf/hamstring and gluteal muscles), at medial arches, non–supporting footwear, increased BMI (Body Mass Index) and occupations that involve stair/ladder use. These factors lead to repetitive over-stretching of the plantar fascia, leading to thickening.
As the fascia thickens it looses its flexibility and strength. The collagen fibres are then prone to degeneration which results in pain.
Plantar fasciitis symptoms
Focal heel pain stretching along the medial arch. Pain is usually worst first thing in the morning and will ease as the foot gets warmed up with activity. As the condition becomes more severe the pain can often become worse throughout the day, especially with weight bearing activities.
Treatment for Plantar fasciitis
Your physio will look to treat plantar fasciitis with the following exercises.
- Advice about avoiding activities that aggravate the plantar fascia
- Soft tissue massage and myofascial release over the muscles of the lower limb can give great pain relief and promote correct biomechanics
- Commencing a home exercise routine of speci c stretching exercises
- Gel pads are used to alleviate pressure on the heel where the plant fascia attaches to the bone
- Education regarding changes to footwear, sporting technique or work habits
- Custom and pre-made orthotics are used to correct foot biomechanics and to support the medial arch
- Depending on the phase of healing, ice/heat can be a very useful adjunct to treatment. Ultrasound therapy is also beneficial
- Cortisone injections have also been shown to be bene cial in persistent cases
- Surgical options are available in extreme cases
Tips for managing plantar fasciitis
These conditions are much easier to treat as an acute condition and can be dif ficult to treat when progressed into the a chronic phase. So if you feel you may have this problem, seek professional treatment immediately rather than letting it linger and hoping it will ‘just fix itself’.
Watch for pain along the outside border of the heel. This may occur due to off-loading the painful plantar fascia by walking on the outside border of the foot which may lead to other biomechanical issues.