What is Plantar Fasciitis
For those of you who have suffered from plantar fasciitis you know the agony of those first few steps in the morning and after resting.
You know the frustration of an injury that seems to take forever to settle down and stops you enjoying the things you love to do.
The plantar fascia is the middle part of a structure called the plantar aponeurosis.
The plantar aponeurosis starts at the inside, far edge of the heel bone (the calcaneus) and extends forwards where, at the mid-foot level, it divides into five sections to join the base of the first bone of each toe.
The plantar fascia’s most important role is to help support the arch of the foot.
Plantar Fasciitis is a Very Common Injury
Plantar fasciitis is the most common injury presenting to the sports podiatrist. Its diagnosis is made based on clinical symptoms that normally include:
- pain localised over the bottom inside part of the heel
- pain with first steps in the morning that settles
- pain with first steps after rest that settles
- increased pain with increased activity and standing
This condition is most frequently seen in:
- people working in weight-bearing occupations, such as factory workers and nurses
- 65% of the non-sports sufferers are overweight
- one foot involvement most common in 70% of these cases
- The condition occurs most commonly after the fifth decade and has been associated with degeneration of the fat pad under the heel bone.
In the athletic population, approximately 10% of all runners will develop plantar fasciitis with long distance running the activity most often associated with this condition.
Sports such as basketball, tennis, football, and dance also have high frequencies.
What Causes Plantar Fasciitis?
We have assumed for many years that plantar fasciitis is caused by excessive stretching of the plantar fascia where it joins the heel bone. Recent research examining the microscopic anatomy, however, suggests bending, shear and compression stress on the origin of the plantar fascia are probably more important than stretching load. New research has also demonstrated that the damaged plantar fascia tissue very rarely demonstrated any properties associated with inflammation. As such, many of us now refer to this condition as a plantar fasciopathy (meaning degeneration of the plantar fascia) rather than plantar fasciitis (which means inflammation of the plantar fascia).
The term Chronic Plantar Heel Pain (CPHP) is an even more recent term used to describe a collection of conditions causing pain under the heel. The internet is awash with many “cures” for plantar fasciopathy however the reality is that there is no one ‘fix-them-all” cure. Everyone is different so the mechanical causes of your heel pain will be different even though the end result may be the same.
How to Treat Plantar Fasciitis
The protocol I use to manage this condition is a client-specific combination of the following treatments supported by the literature and scientific evidence.
- Icing to control pain
- Gentle stretching of the plantar fascia
- Taping of the foot
- Custom prescribed foot orthotics (if appropriate)
- Shockwave treatment (especially if the condition has been present for many months)
- High load strengthening exercises of the plantar fascia
- Strengthening of the muscles crossing the ankle joint
- Calf stretches/ dry needling
- Cortisone injection for recalcitrant conditions
Plantar fasciitis should not be a life sentence. It can be managed and the pain dealt with.
I'm so confident I can help you that I'd love to chat with you personally about your plantar fasciitis, it's what I'm passionate about!
Contact us on 8330 0004 or book online.
Yours in helping build amazing lives from the feet up.
Director of Complete Podiatry