Plantar fasciitis is an inflammatory condition of the plantar (sole) surface of your foot. The plantar fascia is the band of tissue between the heel and ball of your foot.
How does it occur?
Plantar fasciitis is an overuse condition. There are several possible causes:
• Gaining weight
• Having either abnormally high or flattened arches
• Wearing high heels
• Increased walking, standing or running
Gaining weight may cause plantar fasciitis especially if you spend a lot of the day up on your feet or wear poorly cushioned shoes. Also the increased weight may cause a breakdown of the heel fat pad and result in heel pain.
In the case of wearing high heels plantar fasciitis may result as the fascia shortens due to the position of the foot in heels. Pain may occur during stretching of the fascia e.g.) when walking barefoot when you get out of bed.
Runners can develop fasciitis when they change the frequency or intensity of their training or where there has been a change in terrain or footwear. Also if runners have a tight calf or Achilles tendon they are more likely to develop plantar fasciitis as there ankle flexibility is limited.
Typically plantar fasciitis initially presents as mild heel pain. The pain usually occurs after (rather than during) running. As time progresses the heel pain can become more severe. The heel pain may occur during walking, standing or even at rest. Classically pain often occurs after resting (eg. getting up in the morning, after lunch) when the fascia becomes stretched again after a period of shortening and rest. Often there is no pain at night as the foot position keeps the fascia in a relaxed position.
Without treatment plantar fasciitis can become a chronic condition affecting foot position and the way you walk. This may then also cause problems with the knees, hips and back as well as limiting your level of activity.
Your physiotherapist will be able to diagnose whether your have plantar fasciitis. In the initial stages treatment will focus on reducing the inflammation.
This would include the use of electrotherapy modalities, gentle massage and stretching, the use of taping to take the fascia of stretch, ice and rest from aggravating activities. Once the inflammation has settled treatment would move onto more intensive stretching of the fascia, calf muscles and Achilles tendon as well as deep tissue massage and releasing of the tension in the fascia.
Treatment would also now look at predisposing factors (e.g. flat arches, running style) and correction of these to prevent further reoccurrences. Finally your physiotherapist will assist you in your return to sport, provide a long term preventative exercise program of stretching and will be able to provide you with advice on things such as footwear.