Photo shows common site of the pain with Plantar Fascitis
Plantar fascitis is characterised by pain in the heel area on the underside of the foot. It is common in runners and may be caused by overpronating ankles. Plantar fascitis is sometimes associated with a heel spur. (bony protrusion on the heel). Plantar fasciitis is the correct term to use when there is active inflammation. Plantar fasciosis is more accurate when there is no inflammation but chronic degeneration instead. can be very painful and debilitating. The pain is usually under the heel on walking/running. Pain is usually worse in the morning in the first few steps. Diagnosis can be confirmed by a sports Physician and Physiothearpist and must be differentiated from other conditions such as heel spurs or stress fractures.
The painful heel is caused by the elongation of the medial arch of the foot when the ankle overpronates. Lengthening of the arch puts a stretch on the plantar fascia under the arch which is pulled away from the heel. This causes an inflammatory response resulting in heel pain.
Sometimes when ‘warmed up’ running the fascia of the foot is more pliable andduring exercise able to absorb the mechanics of stretching, however when rested the fascia cools down and becomes less pliable and pulls at its insertion on the heel creating the pain.
In order to treat the problem a biomechanical analsyis is needed. Our Sports Physiotherapists at Back in Action Physio will assess the foot carefully. There may be overload from a problem elsewhere in the body causing increased stress on the plantar ligaments. Orthotics may be prescirbed if overpronation is a problem. Taping can be used for more temporary relief of symptoms by supporting the medial arch. Other modalities such as electrotherapy may be used alongside soft tissue manipulation in an attempt to treat the fascia.
Plantar Fascia stretching may be needed to reduce the stress on the underside of the foot. Strengthening is also often required. Strengthening is aimed at the intrinsic muscles which support the arch of the foot. The calf and tibial muscles may also need strengthening. Self massage techniques may be taught by the sports physio to the client for home management.
As the condition is of an inflammatory nature then icing the area is very important. This condition if left untreated may develop into a heel spur which will take much longer to deal with.
Steroid injections are often sometimes prescribed by a Physician can be successful in pain relief however the pain often returns if the cause of the condition has not been addressed.