What is the Plantar Fascia?
Your Plantar Fascia is a thick fibrous band of connective tissue. The plantar fascia is like a thick tendon or ligament that starts at the heel bone and extends along the bottom of the foot to your toes.
The reason you have a plantar fascia is so that it passively stops your foot from over flattening at the arch of your foot. The plantar fascia also helps provide your brain with proprioceptive feedback about the position of your ankle and foot and therefore is very important in maintaining your balance.
Plantar Fasciitis- What is it?
Plantar fasciitis symptoms usually reported as pain under your heel or in the arch of your foot in the morning or after a period of resting your foot, eg after sitting for a period of time.
Most of the time your plantar fasciitis symptoms will be worst with the first steps you take after getting out of bed in the morning and usually the pain or symptoms decrease with activity during your day.
Plantar fasciitis occurs in about 3.6% to 7% of the average population. In runners plantar fasciitis is accountable for up to 8% of all running injuries sustained.
Plantar fasciitis is the end result of chronic degenerative changes at the origin of your plantar fascia at the heel bone (calcaneum)
What causes Plantar Fasciitis? Am I at risk of getting Plantar Fasciitis?
If your calf muscles are very tight, you have stiff ankles from a previous ankle sprain or injury or your big toe is stiff, this can predispose you to getting plantar fasciitis. If you then participate in sports that incorporate a lot of running or if you run or walk long distances, this limited ankle movement will cause you to have an increased risk of developing plantar fasciitis.
The heavier we are the more weight we carry around and this can increase the direct strain on your plantar fascia.
Standing and Walking
If your job involves walking or standing on hard surfaces this can also predispose you to an increased risk of getting plantar fasciitis.
Wearing shoes that do not support your foot arches increases the pressure and load through your plantar fascia.
The biomechanics of your foot ie if you have pronated flat feet or high foot arches this can change the shock absorption ability of your plantar fascia causing it to stretch. This will strain your plantar fascia.
Foot Muscle Weakness
If your small muscles (intrinsic foot muscles) are weak the muscle will fatigue and have limited or poor control over your foot position. This can overload your plantar fascia and cause injury.
Reduced Ankle Mobility and Big Toe Mobility
If you do not have full range of movement in your ankles or your big toes this can increase the loading of the Plantar Fascia.
If you have heel spurs (calcaneal spur), which are diagnosed via x-rays, this will contribute to a greater risk of developing plantar fasciitis.
How do we Assess Plantar Fasciitis?
We may assess your walking or running technique and functional movement patterns such as your squat, lunge, jump and hop to see how your foot and leg moves.
Treatment of Plantar Fasciitis
Treatment for plantar fasciitis pain, may consist of, initially avoiding any aggravating activities to reduce further irritation. Hands on physiotherapy treatment of your plantar fascia may include calf and plantar fascia stretches, soft tissue release of your calf, foot and plantar fascia, dry needling physiotherapy, strengthening exercises for your foot, hip and lumbo-pelvic area, joint mobilisations of your ankle, foot and big toe, ice therapy, taping and high load strength training. If you are a runner we will discuss appropriate shoe selection as important in your overall recovery.
The key thing to remember is that early physiotherapy intervention is best if you are experiencing any foot or heel pain. Allowing your foot condition to become chronic by persisting with aggravating activities and not addressing the cause of your foot or heel pain will only increase your symptoms, eventually have you out of your sport or running for more time and delay your recovery.