Plantar fasciitis is the most common cause of foot pain we see in the clinic!
The plantar fascia is a ligament that runs along the bottom of the foot, from the heel to the toes. Its primary function is to support the arch and is involved in the function of the big toe joint.
If excessive force is placed through the plantar fascia it can result in inflammation and micro tears of the soft tissue that makes up the plantar fascia, causing pain. Plantar fascia is characterised by pain on standing, especially first thing in the morning. Symptoms will often then ease off before returning with a vengeance later in the day!
Plantar fasciitis occurs as a result of repetitive strain combined with underlying biomechanical factors. A number factors can contribute to this including:
– Flat feet
– High arched feet
– Being overweight
– Sudden increase in physical activity
– Traumatic injury
– Wearing shoes that are unsupportive or ill fitting
– Being on feet for most of the day
– Underlying medical conditions
– An abnormality in gait (walking) cycle or foot type that places excessive force on the fascia
– Tight calves
– Muscle weakness
– Contracture (tightening) of the plantar fascia
How is plantar fasciitis diagnosed?
Plantar fasciitis can usually be diagnosed through a thorough clinic assessment. In some cases we may require x-ray and/ or ultrasound imaging to rule out other conditions. Your podiatrist can write any referrals required for imaging but if you have already had some scans, be sure to bring them with you to your appointment.
There are a number of conservative treatments that when used in combination have been shown to effectively treat plantar fasciitis. These include:
Orthotics: Orthotics are used to alter forces during standing and the walking cycle. They can address biomechanical abnormalities and reduce the plantar fascia’s exposure to forces. They may be required for more chronic cases or severe abnormalities and are used as both a treatment and preventative measure
Shockwave therapy: Shockwave can be used as both a stand alone or adjunct therapy to help expedite the healing process. It is a non-invasive treatment meaning you are able to continue on with your normal day following treatment. If you have suffered with plantar fasciitis for a long period and want to get back to sport as soon as possible then this is a perfect treatment method to add.
Footwear: Shoes should provide support and protect the foot while allowing it to function efficiently. Features of the shoe to look for include effective shock absorption, firm heel support and a secure lacing system.
Stretching and strengthening: This is imperative in any treatment plan as it creates a strong and flexible foot that is capable of absorbing and redistributing the force that our feet experience daily. Our podiatrists tailor programmes to suit each patients’ needs.
Taping: Taping is extremely beneficial in reducing forces through the plantar fascia particularly in early stages of plantar fasciitis, for both temporary symptomatic relief and diagnostic purposes.
Manual therapies: These may be included in the treatment plan to speed up the healing process by physically releasing tight and affected muscle groups. Manual therapies may include massage, dry needling and joint mobilisation.
Frequently asked questions about Plantar Fasciitis
Recovery time from plantar fasciitis ranges depending on the duration and severity of the condition. The plantar fascia receives little blood flow compared to other types of tissue such as muscle and can take extra time to heal. If only a mild case, symptoms can start to decrease within weeks with complete resolution of pain in 6-10 weeks. For more severe cases complete recovery may take longer however in 90% of cases symptoms improve dramatically within 2-3 months. If left untreated this can become a chronic condition resulting in compensation in other areas including the hip, knee, ankle and back.
Plantar fasciitis is the most common cause of foot pain that is seen in the clinic. Research has suggested that it affects 3.6% of people at any given time and up to 10% of people over the age of 50. The condition affects females more often than males.
It is suggested that approximately 50% of people with plantar fasciitis symptoms also have a heel spur. However, it is important to understand that heel spurs themselves are not the cause of pain. Many people may have a heel spur and be completely asymptomatic and unaware that they have one.