Plantar Fasciitis

Plantar Fasciitis is a common source of heel pain. It occurs mainly in runners and the older adult.

The plantar fascia is a thick fibrous band of connective tissue that originates from the calcaneus (heel bone) to the ball of your foot. It provides support to the arch of your foot by limiting over pronation and keeping the bones and joints in position. It also helps to absorb shock through the foot as well as aid in the forward propulsion of your gait.

Cause

Plantar Fasciitis can occur as a result of overuse of the plantar fascia or overstretching which can cause inflammation. It may also be associated with a heel spur.

This condition usually occurs in runners, those who participate is high impact sports or the older adult. It is often associated with a biomechanical abnormality such as excessive pronation or supination of the foot.
It commonly results from activities that require full plantarflexion of the ankle as well as dorsiflexion of the toes e.g running or dancing.  For the older patient, the cause may be related to excessive walking in non-supportive footwear.

Other risk factors include obesity, weight bearing occupations, pregnancy or tightness in surrounding structures such as calf muscles, hamstrings and/or gluteal regions.

Signs and Symptoms

Pain is usually of a gradual onset and felt on the inside of the heel. The pain is typically worse in the morning, or with the first few steps after waking and then improves with exercise. The pain is often aggravated by standing for long periods or after inactivity. The plantar fascia is often tender to touch from the heel bone up to the inside of the foot. The plantar fascia is often tight and thus stretching of this structure may also reproduce pain. There may also be mild swelling in the heel.

How is it diagnosed?

Plantar fasciitis may be diagnosed by your physiotherapist or doctor based on your symptoms, clinical history and physical examination.
An Ultrasound or MRI may identify swelling or thickening of the plantar fascia.
X-rays are not essential for diagnosis they may show a heel spur, however this may or may not be symptomatic.

Treatment

Plantar Fasciitis responds well with conservative management and most people will notice a significant improvement in their symptoms within the first few months of treatment.

Treatment may include:

• Rest, avoidance of the aggravating activity

• Ice

• Nonsteroidal Anti-inflammatory drugs (NSAIDS)

• Stretching

• Massage

• Strengthening exercises

• Taping

• Prescription of orthotics, splints or heel supports

• Footwear with well-supported arches and midsoles

If conservative management is unsuccessful, your doctor may consider corticosteroid injections or surgery.

Prevention

To minimize your risk of developing plantar fasciitis:

• Keep within a healthy weight range to reduce the stress on the plantar fascia

• Wear supportive shoes

• Regularly replace old/worn out running shoes

• Gradually increase exercise duration and intensity if starting a new exercise program

• Ensure adequate warm up and cool down when exercising

• Try low impact sports e.g. swimming or cycling rather than jogging or running

• Stretch surrounding muscles such as calf muscles, hamstrings and gluteal muscles

• Exercise the muscles of your foot to improve the arch support and decrease the stress on the plantar fascia

If we can help you with any of your foot aches or pains, please feel free to contact us:

Phone: 9553 8145
Website: www.eqphysio.com.au
Or if you're in the area, drop on by and have a chat with us to see if we can help in any way. We're located at 1/45 Montgomery St, Kogarah NSW 2217.