What is it?
Plantar fasciitis is a very common cause for heel pain and pain along the long arch on the bottom of the foot. It is a modern day illness caused by regular walking over hard surfaces in the workplace, home, shopping centres, footpaths, and so forth. It is the pulling and micro tearing of the large ligament type structure under the foot called the plantar fascia at its insertion at the heel. The cause of this injury varies from patient to patient but is a problem with the weight bearing function of the foot. As such factors such as age, weight, spending long periods of time on the feet, excessive forefoot sports and starting exercise after a long period of inactivity are common contributing factors. Overpronation (“flat feet”) is the most common biomechanical cause of plantar fasciitis. As the foot rolls inwards (“flattens”) this lengthens the long arch of the foot and puts added tension on the plantar fascia which can lead to inflammation. Sometimes in an effort to heal the plantar fascia the body will form bony spurs on the heel, although these are rarely the cause of the pain.
Plantar fasciitis is commonly more painful with the first few steps in the morning and again in the evening time. It is also aggravated by continuous activity such as running, toe walking or climbing stairs.
4 Life Podiatry
Initial treatment from our podiatrist will be aimed at reducing pain and inflammation and correcting the biomechanics to offload the plantarfascia. This can be best achieved by :
- Arch supports, orthotics or heel pads
- Taping to support the plantar fascia and allow rest
- Achilles and calf stretches
- Gentle stretching of the plantar fascia
- Appropriate anti-inflammatory medication as prescribed by a doctor or pharmacist
- Podiatry Treatment, including massage, ultrasound, a thorough assessment to identify contributing factors and development of an exercise program to correct these
- Education and advice regarding training/exercise, warming up and cooling down, weight loss and appropriate footwear
Stubborn cases of Plantar Fasciitis also respond well to Extracorporeal Shockwave Therapy.
Prevention & Home Management Strategies
Prevention of plantar fasciitis includes wearing appropriate footwear, correction “flat feet” by wearing orthotics and performing regular stretching. A personalised exercise program can be developed by our Physiotherapists or Podiatrists to further aid in prevention.
Once treatment has commenced for plantar fasciitis the following home management strategies can also assist:
- Relative rest from aggravating activities
- Icing the affected area for 20minutes twice daily.
- Wearing supportive shoes with an arch support
- Performing your home exercise program daily
- Maintaining a healthy body weight.