Do you get up in the morning and the first few steps resembles treading on broken glass?
About 10% of the population will suffer heel pain at some point, and its likely that it lasts for a significant time. Even worse, is that it will affect you ability to exercise and perform day to day activities.
What is the Plantar Fascia?
The plantar fascia is a broad band of fibrous tissue that runs along the the plantar (bottom) surface of the foot. The plantar fascia is attached to the calcaneus (heel) and supports the arch by acting like a bow string. When the plantar fascia is stretched excessively (often due to excessive pronation), it can cause the fascia to start to pull away from the heel attachment resulting in inflammation and pain.
What is Plantar Fasciitis?
Plantar fasciitis is generally the result of faulty biomechanics. Excessive pronation, or a high strike angle supinated foot structure, can cause the plantar fascia to elongate and tear at the attachment to tuberosity of the calcaneus.
Excess pronation lowers the arch structure and as the foot elongates, a traction force is placed on the plantar fascia. These tractional forces can result, over time, in inflammation of the fascia and surrounding tissues, thus causing pain in the arch and heel. If chronic traction of the plantar fascia from the calcaneal tuberosity occurs, then this may lead to the development of a bony growth on the calcaneal tuberosity. The resultant projection or bone growth may be called a ‘spur’ – referred to as a ‘heel spur’ – which can be visible on X rays. Plantar fasciitis is generally a precursor to a heel spur.
The presence of tight calf muscles can often add to plantar fascial pain due to restriction in dorsiflexion of the foot during the propulsive phase of gait. When these factors are combined with excess pronation, this results in the foot dorsiflexing at the midtarsal joint which in turn places an extra strain on the plantar fascia.
Symptoms of Plantar Fasciitis
Sharp pain, stiffness and aching are very common with this ailment. Patients often present with a dull to sharp pain occurring about the plantar calcaneal area when getting out of bed of a morning. The plantar fascia is more inflexible at those times or when arising from a seated position and continuing during the initial periods of weight bearing. Usually the pain subsides within a few minutes, but may re-occur once this sequence is re-established. Pain can also occur after excessive periods of walking or running activity.
The pain is often described by patients as a ‘stone bruise’. Pain can be located at the inferior aspect of the heel either medially, laterally or centrally.
Plantar Fasciitis is more common in overweight patients, pregnant women, people who have recently increased their level of activity.
Treatment of Plantar Fasciitis
Treatment of plantar fasciitis will begin with a full assessment of the condition by one of our experienced physios. This will ensure that we get to the root cause of the problem and address all the factors that may be contributing to the pain.
Plantar fasciitis is most successfully treated by realigning the biomechanical structure of the foot. Custom Orthotics are prescribed and fitted to the patient to;
control excessive subtalar joint pronation
prevent over-stretching of the plantar fascia
correct any other biomechanical problems contributing to the pain
Other treatment will include manual therapy and an exercise program designed specifically for you to help stretch out tight soft tissue structures and strengthen weak muscles.
Our physiotherapy management will not only help relieve your pain, but help prevent the problem from reoccurring in the future.
The most important thing is that you get back to the the activities that you love doing!!!