Plantar Fasciitis (Plantar Fasciopathy)
By Laurence Schubert APAM
What is Plantar Fasciitis?
Plantar Fasciitis (Plantar Fasciopathy) is a painful overuse condition in which the plantar fascia causes pain at the heel in and along the arch of the foot. Formerly known as plantar fasciitis, plantar fasciopathy encompasses other aspects of heel pain. The plantar fasciitis is a strong fibrous connective tissue (aponeurosis) that originates from the calcaneus (heel bone) and attaches to the metatarsal heads on the plantar (sole) surface of the foot.
What are the symptoms of Plantar Fasciitis?
A hallmark of plantar fasciitis (fasciopathy) is pain in the morning, during the first few steps when getting out of bed. Pain will begin to ease the more you walk and generally decrease when performing other physical activity. However, upon completion of the activity, an aching pain will return. Plantar fasciitis is generally an insidious onset and symptoms increase gradually over time. Pain will present on the medial inferior aspect of the heel and sometimes run along the arch of the foot. As the conditions worsens, pain may be present with standing and worsen with activity. Plantar fasciitis may present similarly to to Sever's disease, however plantar fasciitis is much more common in adults, where as Sever's disease presents in children and adolescents.
What causes Plantar Fasciitis?
As this condition is primarily an overuse condition, the most significant factor is training volume. This includes any changes in amount, type and intensity of training. Any activity that produces repeated stress on the plantar fascia are likely to cause plantar fasciitis, e.g. running. People who spend majority of their workday standing are also at an increased risk. Other suspected risk factors include; higher BMI, poor foot alignment (decreased arch), sedentary behaviour, decreased foot and ankle flexibility, decreased strength of the calf and intrinsic foot muscles.
Can Plantar Fasciitis be treated?
Definitely! As you can see above, the most significant cause of plantar fasciitis is amount of load through the foot. Therefore, one of the most modifiable risk factors can be addressed through changes of training volume. A period of relative rest may be required, reducing activities that aggravate your heel pain. If possible, reducing the number of hours standing at work. Other modifiable treatments include; increasing support in your heel or changing to a more supportive shoe and foot orthotics.
When working with your physiotherapist, treatment will begin with a conservative approach and if the plantar fasciitis fails to respond over a period of treatments, then further imaging or corticosteroid injection may be required. Physiotherapy will focus on addressing any contributing factors such as; reducing muscular tightness, improving ankle joint mobility, strengthening and stretching exercises. Further treatment that has been shown to be effective is taping of the foot, your physiotherapist can complete this for you to help manage with your pain levels. Below are two home exercises that can get you started on your way back to pain free living.
Some home remedies for Plantar Fasciitis:
· Frozen drink bottle roller
o Freeze a firm drink bottle and roll the arch of your foot up and down the drink bottle. This will achieve two things; the application of ice and massaging the plantar fasciitis. Ice is particularly effective for reducing pain levels in the heel. Begin with 2 x 5-minute bouts per day.
· Self-massage of your arch and lower calves
o Cross your leg over your knee and begin to use your thumbs on the arch of your foot and working up to the lower calves. This will release any increased muscle tension that is contributing to your pain. Begin with 2 x 5-minute bouts per day.