What is Plantar Fasciitis…?

The Plantar fascia is a long band of tissue which lies under the sole of the foot connecting the heel bones (Calcaneus) to the toes (Metatarsals). It has a supportive role acting as a shock absorber when walking and running and assists with formation of the in step or medial arch.

Plantar fasciitis is a condition when where the plantar fascia either becomes damaged suddenly by an injury or over time by wear and tear known as RSI (repetitive strain injury). In both cases the end result is the same, the tissue of the Plantar Fascia thickens due to inflammatory changes caused by injury or RSI.

The physical change within the structure causes tightening and restriction of the movement of the fibres. This is what causes the pulling sensation a lot of clients describe and subsequently with increased load the end result is pain, stiffness and dysfunction.

Additional causes of this may also relate to over pronation (Flat footed) or walking on hard surfaces. People who have an active job such as postmen, long distance runners, people aged 40-70 and those who are overweight are most at risk of developing plantar fasciitis. A combination of these “risk factors” will increase the likely hood of the condition developing

Symptoms

Symptoms include heel or arch pain, particularly in the morning where the foot hasn’t been mobilised and is stiff. Diagnosis can also be assisted with Ultrasound imaging but this is rarely done nowadays.

With activities which increase the load going through the foot, the symptoms will be aggravated and leads to restriction of physical activity such as running, tennis and many other court related sports.

Treatment

The most important treatment for plantar fasciitis is REST!!! If we do not rest from physical activity the inflammatory process will be fuelled due to aggravation of the condition. This will only set you back and it will take longer for your symptoms to fully resolve!

ICE is extremely important, to reduce the effects of and the length of time the inflammatory process lasts for we need to use cold therapy. Put a small bottle of water in the freezer and roll your foot over the bottle. This will help to cool the area reducing inflammation and you can also use it to massage the foot at the same time! Spend about 10 -15 minutes every evening doing this.

Strapping under the sole of the foot helps to support the plantar fascia and relieve some of the stress placed on it when walking or running. This is especially good if the symptoms are new as the support provided reduces the likely hood that the Plantar Fascia becomes irritated and this aids the healing process.

Stretching the calf is also important as the Plantar Fascia is actually an extension of the achilles tendon. There is positive research evidence to show (and positive results in clinic too!!) that stretching the calf reduces pain and stiffness in the Plantar Fascia. There are two main  muscles which make up the calf, see the pictures below for guidance on these.

This stretches the Gastrocnemius muscle! This  is the larger of the two calf muscles, you should feel the pull at the top of the calf and into the back of the knee.

Position yourself as shown in the picture to the left, try to push your knee straight and your heel to the floor. Then move your hips forwards keeping your heel on the floor and your knee straight.

Hold this position for 20 seconds and repeat 2-3 times. Frequently throughout the day!

This stretches the smaller of the two muscles, Soleus. When stretching this muscle you should feel the stretch at the bottom of the calf and potentially into the achilles tendon.

Position yourself as shown in the picture to the right, try to push your heel to the floor as you bend the knee. Then try to do a little squat keeping your heel on the floor. You should feel the stretch in the back leg (Right leg in the picture)

Hold this position for 20 seconds and repeat 2-3 times. Frequently throughout the day!

The third stretch is specifically for the plantar fascia. Stand in the position shown in the picture to the left.

Try to push the ball of your foot into the corner of where the wall meets the skirting board. You may feel a stretch in the sole of the foot at this point. If not, try to push your hip towards the wall, this will put more pressure through the foot and will increase the intensity of the stretch.

Hold for 20 seconds and repeat 2-3 times, frequently throughout the day.

More treatment options….

Provision of insoles to support the foot and specifically the instep can be a useful tool for chronic conditions.

Pain may also be relieved by the use of NSAID’s. (Non Steroidal Anti-Inflammatory Drugs)

This information should not be taken as a form of diagnosis and you should consult your Physiotherapist for a thorough assessment and  confirmed diagnosis.

I hope you have found this blog useful, any comments or feedback is always appreciated.