Plantar Fasciitis is a painful condition that develops as inflammation of the thick fibrous tissue, called the plantar fascia that covers the sole of your foot, running from the heel to the base of the toes. Under normal circumstances the plantar fascia acts as an arch or supportive sling to absorb the weight of your body. If the tension becomes too great, the plantar fascia will inflame or buckle under the pressure, causing pain and dysfunction.
Causes of Plantar Fasciitis:
- Flat feet or poor foot biomechanics (overpronation, high arches, knocked knees), altered or poor pelvic mechanics causing uneven weight distribution and pressure through the arch
- Weak intrinsic foot and lower leg muscles that control or support your arch
- Improper shoes – shoes that are too worn, loose or flat giving no support, or high heels causing a short achilles tendon
- Over training – increasing the training frequency or intensity too quickly without adequate stretching or recovery. This is more common in runners
- Excessive body weight – applying an overload to your arches
- Pregnancy due to a change in the centre of gravity, leading to an increase in pressure through your arches
The first symptoms of Plantar Fasciitis include pain:
- in the mornings
- initially under your heel, or
- during the first few steps after periods of inactivity
It is important to see your health professional as heel spurs, fractures and tears in the plantar fascia can have similar symptoms. Diagnosis of plantar fasciitis is usually based upon pain presentation, history and clinical examination. Ultrasound scans may be required to confirm the diagnosis if there is a traumatic onset, like a fall, or if symptoms do not change.
Management options may include:
- Osteopathic or chiropractic treatment to assess and address pelvic imbalance issues that may impact on the plantar fascia. Treatment may then be utilized to break up the inflamed fibres to reduce pain and dysfunction. Treatment may include soft tissue techniques, stretching, mobilisation/manipulation and dry needling
Other techniques or home remedies to help manage this condition include:
- Ice- 2-3 times per day for 5-10 minutes. Place a small water bottle in the freezer, filled with water, then when frozen roll foot over it whilst sitting
- Rest- alternating to swimming instead of impact exercises
- Stretches – calf muscles as well as the plantar fascia
- Soleus muscles stretch, below gastrocnemius stretch
- Plantar fascia stretch
- Strengthening of arch with toe curling exercises
- Improving your running technique
- Golf ball rolling to arch of foot whilst sitting
- Shoe assessment and possible referral to Podiatrist
- Taping with rock tape or kinesiology tape for added support, initially and then for return to sport
- Corticosteroid injections can be used for pain management, but have also been suggested to cause weakening of the tissue, & therefore may cause further dysfunction in the long run, (pardon the pun!) so should be avoided if possible and always seek conservative management first
Most people with plantar fasciitis, with early intervention, treatment and the correct management can resolve the issue and be active with no on going issues.
If you do suffer from foot pain, contact the team at Body Of Life Health Centre for an assessment today.
Article written by Dr Alexandra Kleydish (Osteopath)