What is Plantar Fasciitis?
Plantar fasciitis is the medical term used to describe inflammation of the plantar fascia at its attachment to the heel bone The plantar fascia is a band of fibrous tissue that runs along the sole of the foot from the heel bone to the base of the toes. The patient reports pain under the heel especially first thing in the morning and on walking. In some cases there is extra bone growth at the attachment of the plantar ligament which is known as a heel spur.
What causes plantar fasciitis?
The onset of plantar fasciitis can be contributed to a variety of reasons. One of these is an increased amount of walking which increases the load on the plantar ligament and results in the inflammation. In addition if there are any underlying issues in the foot such as a dropped arch or a high arch the extra load on the ligament can result in this injury. In some cases poor unsupportive footwear can contribute to the problem. It is also thought that tight calf muscles can adversely affect the biomechanics of the foot and may be a factor in the development of plantar fasciitis.
How do we treat plantar fasciitis?
The physiotherapist will usually recommend that the patient stops or reduces the amount they are walking initially. If the area is very tender it is useful to apply ice packs to reduce the inflammation and it may be helpful to take a course of anti-inflammatory medication.
The physiotherapist will carry out a biomechanical assessment of the patient and use this along with the subjective history to identify the contributing factors to the patient’s condition. The aim of the treatment programme is to reduce these contributing factors and manage the patient’s symptoms. Treatment usually comprises of a combination of stretching exercises, electrotherapy modalities, strapping of the foot and orthotics. Another option for the patient is to be referred for a steroid injection but if the underlying causes are not addressed the condition may return.
Exercises to help with plantar fasciitis
The following exercises may be recommended by your physiotherapist:
- Regular calf stretches. Stand facing a wall. Place hands on wall and step the affected foot behind keeping the toes facing forward. Bend the front knee and lean the body forward to feel a stretch in the back calf muscle. Make sure the back heel is on the ground, the back knee is straight and the arch of that foot is not collapsing in. Hold the stretch for 15 seconds and then lean in a little more if you can for a further 15 seconds. Release the stretch and repeat 3 more times. Do these stretches 3 times per day.
- Standing in front of a mirror pull up the big toes and then the other toes to lift up the arches. Release the toes. Repeat x 10. Build up to 5 sets of 10. Repeat 2 to 3 times per day.
