Plantar fasciitis is a foot condition that requires strict and diligent management. Without appropriate intervention, the condition can last up to weeks, or months and reoccur over the course of years. It commonly affects people who are under a high-intensity running load, however, can happen in everyday people too just want to exercise. Management by a professional can help you get back on track.
The plantar fascia itself is a strong and thick bundle of connective tissue that runs beneath our feet. It runs from our heel bone, along the arch of our foot to the toes. It provides support to the arch of our foot, and plays a vital role in the mechanics of walking, running and jumping.
What happens in plantar fasciitis, is the connective tissue becomes irritated. Fascia itself is found all over the human body and has a rich nerve supply making it a highly innervated and sensitive structure. Its function is to hold structures like muscles and organs in place. But much like muscles, they can become tight, irritated and painful. This is what occurs in plantar fasciitis, where the fascia found deep in the sole of our foot, becomes irritated, causing pain in and around the heel of the foot.
Plantar fasciitis symptoms include
If you have symptoms similar to these, it’s likely you have plantar fasciitis. Without proper help, these symptoms will only worsen and won’t go away. As you can see, it is a painful condition that greatly impacts physical activity, and can stop people from doing what they love, like sports or walking the dog.
There are a variety of risk factors that can increase the risk of developing plantar fasciitis. These will be discussed below.
Studies have shown that pes planus (flat feet) can increase the risk of suffering from plantar fasciitis. This has been attributed to increase in load and shock absorption placed through the plantar fascia in those who have a lesser arch.
When we run, if the foot has too much pronation or not enough supination, this has shown to negatively impact the plantar fascia. It’s important to have a professional explain to you what those movements are and have them analyse them in your walking and running.
Activities where we are required to flex our foot but extend our big toe, like dancing on our toes or sprinting on our toes repetitively, can place stress on the plantar fascia and irritate the structure.
There are other risk factors such as a high BMI, tight calf muscles and restrictions in ankle range of motion which have also been linked to plantar fasciitis. Being able to modify these risk factors where possible will be a part of rehab and prevention in the future.
Recovery from plantar fasciitis can vary. Generally, treatment is needed for a period of around 6 weeks. In some instances, it can be shorter but is more likely to be around or over that 6-week mark. In some cases, it takes months for the condition to settle down. This is why being monitored by a professional in this condition is crucial, as it can be debilitating for quite a significant amount of time. In more significant presentations, patients can require surgery, however, the outcomes of surgical intervention are not always successful. Exercise rehab should be the first line of management used in plantar fasciitis, and research has demonstrated it can be extremely successful.
The first step in obtaining an accurate diagnosis is having your pain examined by a professional. At Peak MSK Physio, skilled clinicians can assess your injury and determine whether you are suffering from plantar fasciitis or something else.
In order to diagnose plantar fasciitis, we look for the symptoms we listed above and look into whether there are also any of those risk factors that were discussed earlier. A key diagnostic tool is assessing what is called the windlass mechanism. Big toe movement is a part of the windlass mechanism and is required for walking, running and jumping tasks. If it is found that big toe related movements like a calf raise cause you familiar pain, that will aid in diagnosing plantar fasciitis.
We will also examine for conditions that mimic plantar fasciitis, or may be a part of the overall problem. Some examples of other soft tissue problems include fat-pad irritation, tendonitis, and bursitis.
Treatment for plantar fasciitis requires careful diagnosis and treatment from a professional. The goal of physiotherapy and osteopathy is to help you return to functioning at the highest level, and get back into walking, running, jumping or whatever activities you want to do, pain-free.
There are a variety of ways to treat plantar fasciitis. Options for manual therapy include:
A tailored exercise program specific to plantar fasciitis will be a major aspect of your recovery. It will likely be based around improving a combination of the following.
If the plantar fascia is being impacted, it's likely because it is unable to cope with the current load being placed upon it. Exercises where there is a focus on strengthening the muscles of the foot and the plantar fascia have proven to be useful in improving the condition. Did you know there are four layers of muscles in the foot? Your plantar fascia needs them to work well.
A tight plantar fascia is a common cause of pain and could require some more mobility through the tissue. Stretches are a great way of lengthening the tissue and providing some relief to the tight structures in the foot.
We are on our feet for long periods of the day most of the time and those of us who play sports only use our feet more. This is where endurance is essential for the plantar fascia, as if the structure is unable to cope with long periods of standing, walking or running, it will likely get sore. Endurance exercises can be prescribed by your physiotherapist or osteopath.
It isn’t just athletes that need power for movement. Activities like going up stairs, walking up hills or even getting up from sitting require power from our plantar fascia. Exercises for power might involve high-intensity calf raises or jumping exercises.
In some severe cases, surgical intervention might be required, however, this is rare and the positive outcomes vary with this intervention. We will let you know if we think this option will benefit you.
Without proper management, plantar fasciitis is likely to linger and limit your ability to do the things you enjoy. Whether you’re a football player, a ballerina or someone who just wants to walk pain-free, we can help you. If you’re suffering from debilitating foot pain, it could be plantar fasciitis impacting you. It’s time to put your health first, and seek help for a manageable condition.