PAIN WITH EVERY STEP - PLANTAR FASCIITIS
The often crippling pain of plantar fasciitis presents at the base of the heel. In the early stages the pain is often described like a bruised bone, or feeling like you have a small stone underfoot. There can be a dull aching pain if you’ve been on your feet for a period of time, or a tightness in the arch of the foot. If left untreated, the pain can become excruciating, making simple activities like walking almost impossible.
The plantar fascia is a thick band of tissue that connects the heel to the toes underneath the foot. When the load through the plantar fascia becomes too much, it can lead to thickening and inflammation of the fascia. A tell-tale sign for many with plantar fasciitis is the discomfort felt when taking their first steps in the morning.
Causes of Plantar Fasciitis
Repetitive micro-tears within the plantar fascia occur as a result of excessive overloading. There is often no one cause for the overloading, rather, a combination of triggers that can lead to the condition.
Increase in exercise load
Plantar fasciitis often occurs following an increase in an existing exercise routine, or the beginning of a new exercise program. An increase in weight-bearing activities including running, walking, skipping or jumping is often to blame. It is common for those who have previously been sedentary to experience plantar fasciitis if they do too much too soon. The pain can also occur with prolonged standing, and can worsen towards the end of the day.
Footwear and Biomechanics
Poor foot biomechanics and shoes that are ‘soft’ or provide little support can be a risk factor. It’s important to invest in footwear that provides adequate support when participating in an exercise program, or if you are on your feet for the majority of the day. This is especially important for those with high arches or flat feet, where the plantar fascia is placed under additional strain.
Muscle tightness
Calf tightness may also contribute to plantar fasciitis. The gastrocnemius tendon inserts towards the base of the heel, if this muscle is tight it can pull and place extra tension through the plantar fascia.
Excess Body Weight
People carrying excess body weight are more at risk of developing plantar fasciitis due to the extra strain placed through the feet to carry the load.
Heel spurs
Heel spurs are bony osteophytes which can be present on the calcaneus. Patients suffering from plantar fasciitis may also have a heel spur but in many cases, heel spurs can be asymptomatic and not be the true cause of plantar fasciitis pain.
Common Signs and Symptoms OF Plantar Fasciitis
One of the tell-tale signs of plantar fasciitis is pain when taking your first few steps in the morning. You may also feel discomfort at the start of your exercise routine which may reduce or disappear as you warm up, only to return after you finish.
Pain that worsens towards the end of your day is also common, particularly in more severe cases.
MYOTHERAPY Treatment OF Plantar Fasciitis
Plantar fasciitis is a self-limiting condition which can take anywhere from 6 to 18months to resolve. Acting early will greatly improve your chances of it resolving sooner.
Remove or modify the aggravator
As with many repetitive use injuries, removal and rest from activities which aggravate the condition is the first step to recovery. In the case of plantar fasciitis, weight-bearing activities including running, walking, skipping or jumping may need to be modified.
Footwear and support
The next step is to review the footwear you have been using, do they provide adequate support?
Patients with flat feet may find arch taping, over the counter arch supports, or custom orthotics may alleviate the symptoms of plantar fasciitis.
Muscle tension release and strengthening
Improving the flexibility of the calf muscles and strengthening the intrinsic foot muscles is an integral part of any treatment plan for plantar fasciitis.
Soft tissue release of tight calf and foot muscles may assist during the treatment stage of plantar fasciitis when coupled with a targeted strength program.
Recommendations for muscle release include massage through the gastrocnemius and soleus complex, along with the intrinsic foot muscles.
One of the best strength exercises for plantar fasciitis involves placing a rolled towel under the big toe while performing double or single leg calf raises every other day. This can be progressed with load or from a step. It is recommended you consult your therapist before you start any rehab program to ensure it is done correctly.
Place a rolled hand towel under the big toe
Slowly raise up into a calf raise. Take 3 seconds to raise up, hold at the top for 2 seconds and take 3 seconds to descend. Repeat 10-12 times each side.
Using a tennis ball or spiky ball on the fascia is also recommended. Place the ball underfoot and roll until your find a tender spot, hold the ball on this spot for up to 2min or until you feel the area release.
At Myotherapy and Movement Clinic, we can work with you to develop an individualised treatment plan to best suit your specific requirements.