• Dr Jessica Sammut

What is Plantar Fasciitis?

You may have heard the term "Plantar fasciitis" before, and if not, I'm sure you or someone you know has complained about a very painful bottom of the foot!


What?

Plantar fasciitis is a common cause of heel pain. The plantar fascia is a piece of strong and thick tissue that runs along the bottom of the foot. It connects the heel bone to the toes, creating the foot's arch.


The plantar fascia is important in shock absorption - In plantar fasciitis the force is too much, or too often leading to inflammation of the plantar fascia, either through over-stretching, overuse or a medical condition.


The plantar fascia also passively contracts during the "toe off" phase when walking and running, which is important in acceleration.

Why?


  • Playing sports that put stress on the heel bone, like running, dance and aerobics.

  • Structural risk factors such as: flat-footed or high arches, over-pronation, tibial torsions

  • Being middle-aged or older.

  • Being overweight.

  • Pregnancy.

  • Spending a lot of time on your feet.

  • Wearing shoes with poor arch support or stiff soles.

  • Tight achilles, calves, soleus muscles.

Plantar fasciitis is often associated with a heel spur which is a spike of bone poking out from the heel bone, but many people have heel spurs without any pain


Symptoms:


The main symptom of plantar fasciitis is pain under the heel, which can be dull or sharp. The foot sole may ache or burn and your heel may be slightly swollen.


Textbook plantar fasciitis will present with pain is worse in the morning as you take your first steps or after prolonged standing or sitting after intense activity, and then may improve as you warm up and get moving.


Other symptoms my include:

  • Localised swelling

  • Aggravation when sprinting (burst speeds)

  • Stiffness

  • Sharp heel pain

  • Worse pain when barefoot or in thongs.

Whole Health Osteopathy example Treatment plan for an athletic patient who runs:


Rest

During the healing process, We advise a decrease the intensity and duration of running, especially speed work and hill training. Knowing how active our patient was, Jess advises to cycle or swim instead to ensure there was minimal impact on the heel.


Stretching & strengthening during inflammation

Jess may give the patient a series of gentle calf and plantar fascia stretches to do three times a day every day. We may also suggest the use a foam roller or massage stick at home to help gently massage the calf area.


Once the inflammation decreases slightly, start to increase the level of these stretches. The introduction of calf raises from a seated position and then moved onto a standing position, eventually with light weights added. In the latter stages, elastic bands are added to help generate a thorough stretch.


Taping

In the initial stages, tape can be used to help support the plantar fascia and arch of the patient. This is particularly important when exercising to ensure the area was supported as much as possible.


Osteopathic Treatment

Treatment is targeted for individual patient needs, but likely would be weekly then fortnightly for the 6-8 week prognosis of acute/sub-acute plantar fasciitis.


Icing

Whole Health Osteopathy advise a patient to ice the area after exercise and in the evening (15 mins on 15 mins off) to help maintain the inflammation. When it comes to icing it is essential the ice is wrapped in a cloth such as a towel to avoid direct contact with the skin.


Orthotics

In some cases the clinic advise patients with similar symptoms to use orthotics, either custom made or over the counter to help correct any biomechanical abnormalities.


For more information on looking after your feet, you can read my top tips for foot care here. If you have been putting up with plantar fasciitis, or know someone who has, direct them to Whole Health Osteopathy to get it under control!

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