The plantar fascia is a thickened band that runs over the sole of our foot and attaches into our heel bone. It is there to provide static support of the longitudinal arch which runs along the length of our foot and provide dynamic shock absorption.
Plantar fasciitis is a common cause of heel pain in adults. The pain is usually caused by collagen degeneration at the origin of the plantar fascia as it inserts into the heel.
Plantar fasciitis is incredibly common. 1 in 10 people will get plantar fasciitis at some time in their lives. It is most common in people between the ages of 40 to 60 years, however it can occur at any age and it is more common in women than men. Individuals with pes planus (low arches or flat feet) or pes cavus (high arches) are at an increased risk of developing plantar fasciitis.
Rather than anatomical differences, overuse is the most common cause of plantar fasciitis in athletes. A history of an increase in weight bearing activities is often common, especially those that involve running, which causes micro trauma to the plantar fascia and exceeds the body’s capacity to recover. Therefore if the athlete has increased the severity, frequency or duration of their training or changes the surface on which they train, all of these factors may put undue forces through the plantar fascia ultimately causing damage.
The plantar fascia is frequently a site of chronic pain (pain that has been more than 6 months in length). The pain will often be on the sole of the foot, potentially running alone the sole of the foot but particularly at the heel bone.
Patients will usually describe pain with their first step on rising in the morning or after prolonged sitting. The onset of pain is usually gradual but it can commence after a traumatic injury. Most of the time diagnosis can be easily made by eliciting pain on touching where the plantar fascia attaches to the heel bone.
Stretching and strengthening programmes play an important role in the treatment of plantar fasciitis and can correct functional risk factors such as the tightness of the calf muscle and weakness of the muscles in the sole of the foot. Increasing flexibility of the calf muscles is particularly important.
Physiotherapy in itself will predominantly consist of a lot of massage of the calf muscles and the muscles in the sole of the foot. Often ultrasound of the sole of the foot may also be used.
At Alpha Physio we have been able to heal plantar fasciitis, however we would suggest that physiotherapy alone is not always the simplest and easiest way to fix this.
Two other common forms of treatment we would use are the use of night splints which are devices designed to hold your foot in a certain position to stretch the plantar fasciitis through the night which we would often loan out to our patients, and the prescription of what are called orthotics.
Orthotics are insoles designed to hold the foot in a better anatomical position. This is the field of a Podiatrist and at Alpha Physiotherapy we can recommend good Podiatrists who we would use to help provide a biomechanical assessment (assessing the way you stand, walk and run) and ultimately prescribing you a good set of custom made insoles that are designed for your feet and your feet only.