What is plantar fasciitis?
The plantar fascia is the thick band of fibrous tissue that lies over the sole of the foot, extending from the calcaneus (heel bone) to the proximal phalanges of the toes. It forms the arch of your foot.
Plantar fasciitis has traditionally been thought of as an inflammatory condition, although recent research suggests that the pain associated with plantar fasciitis is due to degeneration of the collagen fibres near their attachment to the heel bone.
Plantar fasciitis is characterised by a sharp stabbing heel pain, which is often at its worst when getting out of bed in the morning. The pain is usually more severe after periods of inactivity, such as sitting, but may also increase toward the end of the day with increased activity.
Plantar fasciitis is caused by excessive strain on the plantar fascia, particularly at its insertion into the heel bone. Risk factors for developing plantar fasciitis include:
- Increased pronation (turning in) of the forefoot
- High or low arched foot
- Increased time spent standing
- Walking on hard surfaces
- Walking in footwear which doesn’t provide adequate arch support
- Tight calf muscles
How can physiotherapy help?
Physiotherapy for plantar fasciitis is aimed at reducing pain in your foot and restoring function. A detailed history helps the physiotherapist understand contributing factors. A physical and biomechanical assessment is performed next to determine the integrity of the plantar fascia (ie whether it is torn or inflamed) and an analysis of gait, foot posture, muscle length and strength is performed. A treatment plan is then devised which may include rest from aggravating activities, ice, stretches, soft tissue massage, taping or orthotic correction.
It is vital that management of plantar fasciitis is immediate as it becomes harder to treat once it is established. Referral to a Sports Physician may be necessary for more severe cases.