Plantar fasciitis is one of the most common sources of heel pain and is one of those injuries that will appear for no apparent reason. The injury can be quite debilitating and can cause high levels of frustration due to the prolonged period of rehabilitation from this injury as it is difficult to completely rest the foot.
As a podiatry clinic we see plantar fasciitis injuries all year around however without doubt, there is a significant influx in patients presenting with plantar fasciitis symptoms when the football and soccer seasons in full swing at this time of year.
You may wonder why this is so, however it simply comes down to the fact that these types of sports are “toe running” explosive sports where there is prolonged over stretching of the plantar fasciitis.
So What Is The Plantar Fascia?
The plantar fascia is a thick, stringy connective tissue that starts at the bottom of your heel bone and extends along the sole of your foot towards your toes. The mechanical functionality of the plantar fascia is to limit the flattening of the arch in your foot. Plantar fasciitis occurs when small tears or inflammation occurs in the plantar fascia.
What Causes Plantar Fasciitis?
There are many ways in which a person will suffer from plantar fasciitis. Two of the more common ways as previously mentioned, plantar fasciitis symptoms can be aggravated by over stretching. This generally means that the arch of the foot has become elongated as a result of either poor foot biomechanics or weakened arch muscles in the foot.
Alternatively, the plantar fascia can be injured as a result of a blunt force trauma. This trauma is likely to have occurred directly under the arch of the foot.
What Are Plantar Fasciitis Symptoms?
The most common symptom that a sufferer will first notice is pain and soreness in the foot arch or under the heel after resting or first thing in the morning. The level of pain will subside as the plantar fascia warms up as a result of movement.
If the condition is not treated in the first 3 months the presence of pain will increase to include the period directly after activity to also including during activity and then finally all of the time.
The progression of the injury is consistent with that of a typical overuse injury and can be further aggravated by the buildup of calcium deposits at the plantar fascia origin (heel spur). The longer the condition is ignored will lengthen the treatment and rehabilitation period.
For sufferers who are used to having high levels of activity or play competitive sport, that this can cause immense frustration due to the complexity of managing the injury.
Diagnosing Plantar Fasciitis
Only a podiatrist can properly diagnose plantar fasciitis. It is not necessary to obtain x-rays before consulting with a podiatrist. Ultrasound may be useful to identify tears, inflammation and calcification, however clinical examination is most often enough to determine the diagnosis.
If the plantar fascia is not directly involved treatment for heel pain may be very different to what Dr. Google reports, please do not prolong seeking treatment.
Healing Plantar Fasciitis
Plantar fasciitis is treatable and the condition can be reversed. Most patients will also see the injury improve within two months of treatment if caught early. If the injury is chronic, longer than 6 months and due to poor foot biomechanics, ongoing treatments aimed at correcting these mechanics will be required along with the potential use of orthotics.
- Rest, Ice & Protect in 1st month
As with any soft tissue injury, the initial treatment of plantar fasciitis is to rest and ice the injury. Whatever activity or movement that provoked the pain should be immediately stopped.
When icing your foot, do this for a period of 30 minutes every 2 hours or when you notice that the affected area is warm or hot.
We also recommend taking an anti inflammatory medication to assist with reducing the pain and swelling. However taking this medication should only occur as directed.
You may also need to wear a plantar fascia brace or have your foot strapped for further pain relief.
- Regaining Motion
Providing that you properly protect the plantar fascia, once the plantar fascia tissues have healed and any inflammation has settled down you are in a position to address the formation of any recent scar tissue.
It is important to address the scar tissue as poorly formed scar tissue can lead to a recurrence of the injury in the future. In order to lengthen and align the tissue via massage, light stretching and light activity.
You should also communicate to your podiatrist any areas of the foot or ankle that are stiff and could limit the range of movement as its essential to avoid placing unnecessary stress of the plantar fascia.
- Restore Foot Arch, Calf & Leg Muscle Control
The foot arch muscles play a crucial role in sharing the load with the plantar fascia and a podiatrist will be able to provide you with foot stabilisation exercises to strengthen the foot arch. Strengthening the calf, thigh and hip muscles will also help with foot stabilisation and will naturally be incorporated into the rehabilitation from this injury.
- Orthotic evaluation
As previously mentioned, your foot biomechanics are the most likely contributor to plantar fasciitis. Orthotics may be required to help correct any dysfunction with the plantar fascia.
- Addressing Running Technique
Since this injury is commonly caused by repetitive running activities in sport, it is quite likely that your running technique is deficient and will need to be corrected.
A podiatrist will be able to identify exercised and build these into your rehabilitation to help minimise the risk of an injury recurrence whilst also improving your running performance.
- Return to Sport
The final component is returning to the activity that had lead to the injury in the first place. Your podiatrist will design a progressive training regime that allows you to safely increase the load on the plantar fascia. This program will ultimately be built around your personal goals following on from the complete rehabilitation from plantar fasciitis.