What is it?
Plantar fasciitis is an overuse condition of the plantar fascia, often associated with inflammation and microscopic tears in the structure due to excessive strain. The plantar fascia is a flat band of connective tissue that connects from the heel to the base of the toes. It play an important role in normal foot biomechanics by supporting the foot arch and providing dynamic shock absorption.
What does it feel like?
The pain is usually of gradual onset and felt on the inner side of the heel. It is often worse in the morning and decreases with activity, and then aches post-activity. In its more severe stage, pain is present in weight-bearing and worsens with activity.
Plantar fasciitis is the most common cause of rear foot (heel) pain with 10% of the population likely to be affected in their lifetime. It commonly affects two groups: 1) non-athletic overweight middle-aged people with occupations that require prolonged standing and 2) younger runners and military personnel from the repetitive striking of the foot in running and marching.
What causes it?
- Training Error – excessive running or unaccustomed load
- Equipment – unsupportive shoes
- Surface environment – uneven, hard unyielding surface
- Obesity – increased stress applied to foot structures
- Flat feet/low arches (pes planus) or high arched foot (pes cavus) leading to increased stress on the strike phase of running
- Tight/short calf muscles
The best way to manage plantar fasciitis is to get it properly assessed. Analysing factors that lead to the increased stress on the plantar fascia is important to assist in recovery and preventing re-occurrence. Physiotherapists are able to assess these factors which may include analysing your gait (walking habits), foot biomechanics, muscle imbalances and training habits. They will then provide strategies to address these factors. Treatment examples include manual therapy, soft tissue massage to loosen tight muscles, exercises, advice and education and using taping or orthotics to deload the structures allowing them to heal.
If you think you have plantar fasciitis, here are 3 quick exercises you can try to help relieve the symptoms
- Make sure you stretch with both your knee straight and your knee bent to target both major calf muscles.
Plantar fascia stretches
- Stretch with your big toe up against a wall. You can also use a frozen bottle or a golf ball to stretch the plantar fascia more directly.
Foot muscle strengthening exercises
- Strengthening the small muscles in the foot helps to minimise pressure on the plantar fascia. Place a towel on the floor and use your toes to scrunch it up.