Plantar Fasciitis

Description

Plantar fasciatis is an overuse condition characterised by damage to the plantar fascia (a strong sheath of connective tissue underneath the foot). It is one of the most common conditions of the foot and effects a wide range of people from athletes to people who are realitively sedentary. It can either be caused by a high force acting on the plantar fascia, such as a tear from jumping or sprinting up a hill or from overuse (micro tearing) which occurs gradually and will progress if not treated correctly.

This micro trauma may be caused by a variety of things but the main aggravating feature is poor foot biomechanics, a classic example is flat feet where the arch of the feet are nonexistent. This collapsing of the arch causes extra stress through the plantar fascia leading to the damage to the plantar fascia, this can easily be fixed by doing simple corrective exercises to help strengthen your feet and ankles or by reviewing your footwear. Sometimes the fault may be elsewhere in your body so a full physiotherapy assessment may be required to identify and correct the causative problem.

If you ignore your symptoms they are likely to get worse, you may develop painful calcification through the plantar fascia or develop problematic calcaneal spurs,
which will not go away without surgery.

Contributing factors:

  • Other injuries to the legs, altering or caused by altered biomechanics of the foot and ankle complex.
  • Sports with a lot of ankle movement: runners, dancers or gymnasts.
  • Poor foot biomechanics, frequently associated with over pronation of the foot.
  • Poor foot wear.
  • Tight calf muscles.
  • A stiff ankle joint.
  • Poor core stability.
  • Poor proprioception of the leg and ankle.
  • A calcaneal spur.
  • Being overweight.
  • Ageing

Symptoms

Signs and symptoms of plantar fascitis include:

  • Tightness through the underside of the foot especially back towards your heal.
  • Pain through the underside of your foot and back to your heal.
  • An ache which is worse after rest, especially first thing in the morning.
  • Pain eases with exercise.
  • Discomfort on running.
  • Pain on palpation of the sole of the foot.

Treatment

Physiotherapy treatment for plantar fascitis may consist of:

  • Massage to the plantar fascia and surrounding dysfunctional muscles.
  • Review of biomechanics.
  • Proprioceptive retraining of the core/hip/knee/ankle/foot.
  • Taping to take stress of the plantar fascia.
  • Mobilisations to the feet and ankles to restore movement.
  • Giving you appropriate exercises so you can do self management of your condition.
  • Stretches to help release the plantar fascia and the calf muscles.
  • Exercises to strengthen your feet and ankles so that you can improve your foot biomechanics without having to use costly orthotics unless absolutely necessary.
  • Reviewing your footwear and making sure it is appropriate for you.
  • Prescribing orthotics if required for poor gait and foot/ankle control.