The What, Why and How of Plantar Fasciitis
Plantar fasciitis is a very common injury that can affect anyone from recreational walkers/hikers, to golfers to high performance athletes. Plantar fasciitis commonly presents as heel pain and often pain radiating down the bottom (plantar surface) of the foot. This pain is often worse upon first rising and first steps of the day, and then in some cases, diminishing as movement occurs. As the condition worsens, this pain may be present throughout the day and especially during activities.
What is the Plantar Fascia?
Plantar fascia is a broad band of dense, connective tissue that runs from the calcaneus (heel) to the base of the toes (phalanges). In long standing cases of plantar fasciitis it is thought it not so much an inflammatory process as actual degenerative changes.
Causes of Plantar Fasciitis?
One cause may be tightness of the calf muscles – the gastrocnemius and soleus. These muscles, via the Achilles tendon, insert onto the calcaneus. If these muscles are too tight, they will limit the amount of dorsiflexion that should occur during walking or running movements.
This can lead to inflammation of the plantar fascia which then may lead to thickening of the tendon.
Walking in footwear that does not provide adequate arch support could also be a cause.
What Is the Treatment?
1) Rest as much as possible. If possible, stop activities that aggravate or cause pain.
2) Ice to help reduce inflammation.
3) Stretching the gastrocnemius and soleus muscles has been shown to have some benefit.
4) A night splint may also be worn which helps to gently stretch the calf muscles and plantar fascia to prevent the tightening up that takes place overnight.
5) Anti-inflammatory medications may be of benefit
6) Shock wave therapy has been shown to have excellent results with some individuals. This uses high intensity sound waves.
7) Tissue rolling with tennis or golf ball. Roll your foot on a tennis ball.
8) Seek professional help – massage or physio
Although local treatments will certainly help with the symptoms of plantar fasciitis, you must also consider looking up the kinetic chain for deficiencies/asymmetries that may be causing the foot problem. Mobility issues in the ankle, mobility issues in the hips, flexibility issues with the hip flexors, inadequate glute activation and even thoracic spine or upper body posture may all contribute to a faulty walking pattern.
Top 4 Things You Can do to Treat or Prevent Plantar Fasciitis:
1) Wear proper shoes fitted for you
2) Stretch the calves (gastrocenemius and soleus) at least once every day!
3) Roll the tissues – roll your foot on a tennis ball, foam roller for hips and glutes.
4) Stop if you have pain during activities and seek help.
Till next time,