Plantar Fasciitis
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!
What causes plantar fasciitis?
Plantar fasciitis occurs as a result of repetitive strain combined with underlying biomechanical factors. A number of 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
- Standing on your 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.
Treatment options
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: The power of shockwaves 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 the needs of each patient.
- 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.