Plantar Fasciitis - What you need to know | Back In Motion

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Plantar Fasciitis - What you need to know

Plantar fasciitis is one of the most common causes of heel pain and is estimated to affect 1-in-10 people during their lifetime – that’s a lot of people!  

Here’s what you need to know.

What is plantar fasciitis?

Plantar fasciitis is a condition that can cause a sharp pain under your heel and the sometimes along bottom of your foot. Plantar fasciitis is caused by inflammation or aggravation of the plantar fascia, which is a thick band of tissue that extends from the bottom of the heel and attaches to the underside your toes.

When inflammation of the plantar fascia is present, pain can range from a dull sensation to a very sharp pain can cause some people to want to avoid running and even in some cases walking.

The plantar fascia itself helps support the natural arch of your foot and acts as a “shock absorber” for your feet. It plays a very important role in your foot mechanics during walking and running!

What causes plantar fasciitis?

Now that we’ve established that plantar fasciitis occurs when the plantar fascia itself is inflamed or aggravated, it’s important to understand the factors that lead to this.  

While there isn’t just one specific cause of inflammation, it can be difficult to discern the exact cause as there are many reasons that can lead to it.

When too much pressure and stretching is experienced by the plantar fascia, that’s when damage, inflammation, or tears can occur in the tissue.

A few of the most common causes of plantar fasciitis pain are:

  • Tightness of lower limb myofascial structures (calf/hamstring and gluteal muscles)
  • Having flat feet or high arches
  • Playing sports and doing activities that put stress on the heel bone, such as running or dance

Other causes of plantar fasciitis are:

  • Excessive training load
  • Being overweight
  • Pregnancy
  • Spending a lot of time on your feet (especially on hard surfaces)
  • Wearing shoes with poor arch support or stiff soles

The one thing that all these causes have in common is that they cause a lot of pressure on the plantar fascia tissue, leading to excess stretching or overuse.

Symptoms

Pain can present as a dull ache throughout the day, or a very sharp pain that lasts all day.

Pain usually develops over time, although once present sufferers can experience very sharp stabbing pain – particularly first thing on the morning, or when they move again after being seated for a long period of time.

Common symptoms of plantar fasciitis include:

  • Pain on the bottom of the heel, or close by
  • Increased heel pain after exercise (not during exercise)
  • Consistent heel pain (this can continue for months)
  • Pain in the arch of the foot
  • Swollen heel area
  • A tight Achilles tendon. (Remember! Your Achilles tendon connects your calf muscle to the bottom of your heel)

Who is at risk of developing plantar fasciitis?

Anyone! (unfortunately)

Inflamed fascia can happen to anyone, from any walk of life if they come across any of the causes of plantar fasciitis.

For example, a running athlete can develop plantar fasciitis due to an overload in their training and a teacher can also develop pain from standing on their feet all day on hard surfaces. It’s important to understand that the common causes of plantar fasciitis can relate to almost everybody! That's why it's important to be aware of the causes so that you can take steps to mitigate the risk of plantar fasciitis developing.

Treating plantar fasciitis:

As plantar fasciitis can occur as a result of a number of factors, it’s important to seek a proper diagnosis from a qualified physiotherapist or podiatrist to better understand the cause of your pain.

The key to treating plantar fasciitis is to reduce the load on your foot muscles to allow the tissue to repair. In the early stages of treatment, rest and pain management are critical in allowing the tissue to reduce inflammation. Other early treatment includes stretching, ice, and some form of soft-tissue therapy.

Depending on the exact biomechanical factors present in your case of plantar fasciitis, treatment can include any of the following:

  • Calf and plantar fascia stretching
    Tight calf muscles can cause plantar fascia pain due to the muscle pulling at the heel joint. This can then result in unnecessary tension in your plantar fascia, leading to pain. In many cases, relief can be achieved by regular stretching of the calf muscles.
     
  • Soft tissue massage of the plantar fascia
    Soft tissue massage and myofascial release of the muscles of the lower limb can also give great pain relief and promote correct biomechanics.
     
  • ESWT: Shockwave Therapy  
    A quick and effective way to treat plantar fasciitis is Shockwave therapy. This works by sending acoustic waves to the troublesome area which causes a healing response involving tissue repair and cell growth.
     
  • Lower leg and foot muscle strengthening
    Your physiotherapist or podiatrist will prescribe you with an exercise program to help strengthen the surrounding muscle groups to help prevent future pain. It’s critical to strengthen not only the arch of the foot but also the other load dispersing structures of the lower limbs such as your calves and hips. A home or gym-based program of progressive strengthening of your calf, foot and leg muscles, stretching, and eventually spring loading and return to sport exercises.
     
  • Orthotic support for your footwear
    Depending on the biomechanical issues in your case, orthotics may be an effective way to treat plantar fasciitis pain. Orthotics are a supportive device used in footwear and work by reducing impact and stress on the plantar fascia. Speak to your podiatrist if this is right for you.

Other forms of treatment can include:

  • Wearing supportive footwear
  • Cortisone injections
  • Dry needling

How can physiotherapy help plantar fasciitis? 

A physiotherapist can help you manage your, pain ,symptoms and mitigate flare-ups through a variety of different treatments. Depending on how severe your pain is and in what stage you're at in recovery, treatment can include:

  • A foot assessment to help determine whether or not you require orthotics or specific footwear
  • Soft tissue therapy of the plantar fascia, or any of the related muscle groups 
  • Stretches, exercises and programs to strengthen 
  • Education and advice about plantar fasciitis and what you can do to help manage symptoms. The more you know about the injury, the more manageable your symptoms will be. 

A physiotherapist will be able to help guide you through the rehabilitation process and get you back to doing what you love! 

Maintaining a healthy weight, staying active and keeping good nutrition will ultimately contribute to lowering your risk of plantar fasciitis and heel pain. If you are looking for assistance in any of these areas, there are many passionate health professionals including Physiotherapists, Podiatrists and Massage therapists who would love to help you achieve your goals and get back to living a pain-free, happy life.

Back In Motion is always here to help you!

With practices Australia-wide, we’re Australia’s leading provider of physiotherapy and related services. Contact us on 1300 859 981 to organise an appointment with one of our physiotherapists or podiatrists and we can help you with your plantar fasciitis and heel pain!