What is Plantar fasciitis and how can it be treated?

By Kassia Portas, Sports Rehabilitation Therapist.

Plantar fasciitis is one of the most common orthopaedic complaints, caused by inflammation of the plantar fascia. The plantar fascia is a thick connective tissue (aponeurosis) that connects the heel to the forefoot, the ‘fascia’ webs out to connect to the heads of the toes. The plantar fascia’s purpose is to act as shock absorbance to the foot, to even out weight distribution during gait and support the arch of the foot. The role of the plantar fascia during walking/running (gait) can be seen when looking at the ‘windlass mechanism’ – a process whereby the plantar fascia elongates as the foot contacts the floor, then recoils (like a spring) during toe-off (the phase between the toes being stretched and then leaving the ground).

There is a lot of pressure through the plantar fascia whilst we are on our feet, walking or running. For most people this will not be a problem, however when plantar fasciitis occurs, there is too much pressure through the fascia. This causes micro-tears to the tissue and over time causes the fascia to become inflamed and stiff. The stiffness causes the movement in the ankle and foot to be limited and causes pain at the attachment of the fascia into the base of the heel. There are still some questions when it comes to the exact cause of plantar fasciitis, and some debate over whether inflammation is the process – or degeneration.

People suffering from plantar fasciitis will commonly find the pain is around the underside and slightly inner portion of the heel bone. The pain tends to build gradually over time and can be felt as a sharper pain, or dull. The foot and ankle will feel stiff and it may be difficult going up stairs. Pain is usually worst first thing in the morning, or after long periods of being immobile – in addition to being worse after being on your feet for a time. Finding a middle point between the two extremes can often relieve the pain and stiffness temporarily.

Although the exact cause of plantar fasciitis is debated, there are common risk factors. These include a recent increase in activity; being on your feet for long periods of time; being considerably overweight; ill-fitting shoes; wearing high heels; injuries or weaknesses in the ankle and calf tightness. Females between 40-60 are most commonly affected.

Treatment is important to start as soon as possible as this will improve the recovery time significantly. Treatment for plantar fasciitis includes rest, ice, anti-inflammatories and physical therapy. In worst cases, orthotics or steroid injections may be considered.

A qualified healthcare professional such as a Physiotherapist or Sports Injury Therapist, will assess various aspects of the foot and ankle in case there is a reason for developing the problem – for example, tight calf muscles. Seeing a therapist to help reduce the pain and stiffness caused by plantar fasciitis will involve mobilising the foot and ankle to restore full range of movement and releasing the soft tissue including muscles in the sole of the foot, front of the shin and calf.

Direct work to the plantar fascia helps to reduce inflammation around the sole of the foot and improve its mobility. Rehabilitative exercises will also be prescribed to improve mobility and muscle tension in between appointments. Advice on ways to manage the pain at home often includes rolling the foot on a roller, ball or ice cold bottle; managing activity levels and footwear. Once the pain has reduced, rehabilitative exercises will be given to improve the strength of the foot and ankle – and if there was anything identified contributing to the development of plantar fasciitis, your therapist will work with you to manage this.

If you are struggling with Plantar Fasciitis then why not book in with one of our health care professionals at out Thornbury, Thornbury Active or Yate clinics or book online at www.thethornburyclinic.co.uk