What is it?
Plantar fasciitis is the most common cause of heel pain and 1 in 10 people will experience this condition throughout their lifetime. It is most simply put pain caused by the inflammation of the plantar fascia tendon which inserts underneath the sole of the foot and is most commonly felt nearer the heel. It is a progressive condition which means it is developed overtime rather than an acute incident causing the pain, and it can unfortunately be a relatively drawn out recovery/rehabilitation depending on your work and lifestyle.
What are the symptoms of plantar fasciitis?
Generally speaking plantar fasciitis is characterised by pain in the heel of the foot and can be experienced in one or both feet simultaneously. It is most commonly experienced as pain upon walking or putting weight on your foot and exacerbated with high intensity exercise such running and jumping as these are movements that put the most strain through the arch and plantar fascia of the foot. One of the key characteristic of PF pain is the morning pain as you wake up, and this is often reported as the “worst” pain they get. Once you walk for a few minutes, the tissue warms up and you get reduced pain until you have another prolonged period of rest and it cools down and stiffens again. In summary, most common symptoms are localised heel pain that is worse in the morning or after sitting >30mins and improved with a few minutes of walking.
What are the causes of plantar fasciitis?
There can be many causes of plantar fasciitis so if you are finding you are getting reoccurring bouts of heel pain that you think may be PF, it may be worth getting an assessment and consultation with a physiotherapist to determine the underlying cause of your pain.
However there are some general causes that you may find relate to you that you can address to try and reduce your own likelihood of getting PF or reducing the duration you battle with the pain:
- Increased pronation of the foot (flat foot)
o Some people who have flat feet may be more prone to plantar fasciitis as they put more strain through the longitudinal arches of their feet when weight bearing. It may be that as a general rule those with flat feet are ok with moderate time on their feet and minimal high intensity activity, however when they increase their running, jumping or standing time that may be when they get overloaded through their plantar fascia and could result in plantar fasciitis.
- Poor unsupportive footwear
o Wearing footwear that is hard under foot and has no support of the arches may cause difficulty for people on their feet for long periods whilst wearing these shoes. Again without the support and because of the hard surface it can stress and irritate the plantar fascia which can lead to plantar fasciitis.
- Gluteus weakness
o Weakness through the glute muscles can cause over pronation at the foot on the same leg and as a result if you have increased time on your feet or walking and are repeatedly over pronating with each step due to inability to stabilise through the glutes you can again cause plantar fasciitis.
- Simply and increase on time on feet standing, walking or running
o You may also have great foot wear, and supported arches and you can still find yourself battling with plantar fasciitis if you have a sudden increase in load and time on your feet. It may be an increase in standing, walking, running or jumping sports and this can over load the feet simply as they are not used to the time under load.
- Weak or constantly tight calves; one or both
o When we have tight calves it can directly put additional load on the plantar fascia, or change the mechanics of our walking gait which also can strain the plantar fascia, and over time this can cause inflammation at the attachment site of the PF into the heel.
o With weak calf muscles it can lead to inadequate support and stability through the foot and ankle as you stand and walk and this can lead to over pronation of the foot and overloading of the plantar fascia leading to plantar fasciitis.
What can you do to reduce the symptoms and get rid of your plantar fascia?
- Reduce the time on your feet and therefore reduce the inflammation and stress through the plantar fascia to help allow it to settle down and be less painful.
- Freeze a half full bottle of water and then place it underneath the sole of your foot and roll your foot along the sole and arch to replicate an ice massage. The massage helps to relieve tension in the fascia of the foot, and the ice and a powerful anti-inflammatory tool to reduce the inflammation in the PF and reduce your symptoms.
- Planta fasciitis socks which are a compression sock help to reduce inflammation, reduce pain and also provide some support at the arch to take away some load on the planta fascia.
- Calf stretching and strengthening to help reduce the tightness and also reduce the weakness if present (can get your physiotherapist to do some testing to determine if you have tight or weak calves). Whether you know you have tight tight or weak calves, there is no detrimental effect to beginning a calf stretching and strengthening program to build the tolerance and strength of the tissue and reduce the inflammation and pain.
- Plantar Fascia taping aims to take some of the load away from the planta fascia so that when you’re walking the tape acts to support the arch and give the tissue time to settle and reduce inflammation and pain.
- If it is really severe, sometimes you can wear a night splint which helps to keep the foot and ankle in a position of length overnight and reduce the shortening of the planta fascia as you sleep and reduce the aggravation with the first few steps in the morning as it tries to lengthen again.
Contact your physiotherapist or doctor to discuss this option.
What services at RIGS can help me to manage my pain and help facilitate the rehabilitation of plantar fasciitis?
- Specialised cryotherapy is a very strong tool to reduce inflammation in the planta fascia which is the cause of pain. A short bout of daily cryotherapy for 3-4 minutes is extremely effective at getting on top of PF pain quickly.
- Compression boots are effective at applying massage to the feet and calves to reduce tension through the tissue that may be causing increased tension through the plantar fascia. It also provides the compression and increased blood flow to the area to again reduce the inflammation in the tissue.
These are the two most specific services you can use to help with this specific condition, however if times allows the contrast water therapy pools with also add a flushing and anti-inflammatory benefit to the body. Additionally they provide some relaxation and lengthening of the tissue while in the heat to improve pliability of the tissue and promote movement and healing to reduce symptoms.
If you think you may be battling with plantar fasciitis and would like some assistance with the diagnosis and underlying cause of your PF then book in with Krystal our Physiotherapist to get an assessment and treatment plan in place to get you back feeling better ASAP. We hope that this helps you but please remember that everyone is different and to contact your health professional if you are concerned with any pain or symptoms you are experiencing.
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