What is the Plantar fascia?
The plantar fascia is a strong, thick band of fibrous tissue that runs along the bottom of our feet. It connects the calcaneus (heel bone) to the distal heads of the metatarsals (just before the beginning of the toes) and plays a significant role in supporting the arch of the foot and shock absorption. Combined with the anatomy of the bones in our feet and the intrinsic muscles at play, the plantar fascia enables our feet to pronate/supinate and absorb force efficiently when we walk and run.
Plantar fasciitis:
Plantar fasciitis is an injury where the fascia itself is irritated or starts to degenerate, either from a spike in training and exercise or from a sustained period of increased training loads with insufficient rest. The main symptoms experienced are:
- Pain when touching the heel or the area underneath your arch
- Stiffness or worse pain in the morning – easing as the day goes on
- Sharp pain when walking or standing in the heel or arch region.
Treatment:
Many factors needed to be addressed in the treatment of plantar fasciitis. For clients who have been experiencing pain for longer than 3-months, often their walking gait and the adjacent knee and hip muscles are no longer working as they should be and must be addressed during a successful rehabilitation. Treatment is always individualised, and what may have worked for one person may not help to reduce your pain as the makeup of our feet varies greatly as well as the activities that we enjoy doing vary as well.
Common treatments:
- Load management
- Foot strengthening
- Hip and Knee strengthening
- Gait retraining
- Shockwave therapy
- Taping and / or Orthotics
- Anti-inflammatories, Icing, injection therapy (In some cases)
What else could my pain be:
Although not as common, the below pathologies can also explain pain that is felt beneath the heel and arch in a similar location to the plantar fascia.
- Heel spurs
- Tarsal tunnel syndrome
- Tibialis posterior tendon dysfunction
- Sesamoiditis or Turf toe
Take Home:
A correct diagnosis and appropriate treatment is key to a good prognosis for heel and foot pain. Clients who seek out management earlier than later tend to recover quicker and with less discomfort or change to routine. Plantar fasciitis can sometimes irritate patients for many years and is therefore crucial that physiotherapy management is commenced as soon as possible.
Jordan Coleman – Genius Physio