Plantar Fasciopathy & The Rationale for an Exercise-Based Approach

What is Plantar Fasciopathy?
Plantar fasciopathy (PF) is a common injury among people who spend a lot of time on their feet (nurses, tradesmen, hairdressers, etc). Most often called plantar fasciitis, (-itis implying inflammation only) plantar fascio-pathy is a term which does not discount inflammation, while also encompassing the likelihood of micro-tears in the plantar fascia.

What Does a Healthy Plantar Fascia Do?
The plantar fascia has many functions. It plays a key role, for example, in absorbing ground forces, supporting the arch, and appropriately redistributing the loads through our feet during gait. When too much is asked of the plantar fascia, it’s micro-fibres can begin to breakdown.

Why Does it Get Injured?
The issue is caused by disproportionate loading of the plantar fascia compared to other soft tissues in the foot and leg (that could potentially better share the load). This overload most often causes pain at the plantar fascia’s attachment at the heel bone. Classically, the pull on the plantar fascia here during the first steps after resting cause the worst pain.

Rationale for the Exercise Approach
There are many ways we treat PF at 4 Life. A tailored exercise-based element in your treatment is essential as it re-trains the soft tissues of the lower limb in different ways to better deal with the loads going through the foot. Soft tissues which are short and tight must be optimally lengthened with flexibility training; soft tissues which are weak must be strengthened.

Flexibility training for PF will classically involve the PF itself, in many cases the calf muscles, and often the hamstrings too. In conjunction with these stretching exercises, or later in the exercise programme, your podiatrist can prescribe tailored strengthening exercises for muscles which are under-developed (or not doing their share of work) to optimise their load-bearing capacity, and reduce the strain on the plantar fascia. Overall, these exercises are aimed to improve plantar fasciopathy symptoms in the short-term and help prevent recurrence of injury in the longer term.