Plantar Fasciitis

22/04/14 8:40 AM


Keith Sobkowiak DPT

Keith Sobkowiak DPT

Anatomy

The plantar fascia is a band of connective tissue that runs along the sole from the heel to the ball of the foot. One of its main roles is to keep the bones and joints in position and enables us to push off from the ground. Bruising or overstretching this ligament can cause inflammation and heel pain. In many cases, plantar fasciitis is associated with a heel spur.

Who is at Risk?

  • High impact activities: running, jumping, aerobics, etc.
  • Flat-footed or high arches. People with flat feet may have reduced shock absorption, increasing strain on the plantar fascia. High arched feet have tighter plantar tissue, leading to similar effects
  • Middle-aged or older. Heel pain tends to be more common with ageing as muscles supporting the arch of the foot become weaker, putting stress on the plantar fascia.
  • Overweight. Weight places a greater mechanical load on the plantar fascia. There is evidence that overweight and inactivity lead to chemical damage to the plantar fascia, with a worsening of pain.
  • Being on your feet. People with occupations that require a lot of walking or standing on hard surfaces may suffer plantar fascia pain.
  • Wearing shoes with poor arch support or stiff soles.

Prevention

  • Maintaining a healthy weight to minimize the stress on the plantar fascia.
  • Choosing supportive shoes. Avoiding stiletto heels and shoes with excessively low heels. Buying shoes with a low to moderate heel, good arch support and absorption.
  • Starting activity slowly. Warming up before starting any activity or sport, and starting a new exercise program slowly.
  • Allowing adequate recovery time between workouts or training sessions.

Signs and symptoms

You may experience:

  • Sharp pain in the inside part of the bottom of the heel, which may feel like a knife sticking into the bottom of the foot.
  • Heel pain that tends to be worse with the first few steps after awakening, when climbing stairs or when standing on tiptoe.
  • Heel pain after long periods of standing or after getting up from a seated position.
  •  Heel pain after, but not usually during, exercise.
  • Mild swelling in the heel

Helpful Hints on Self Care

  • Gentle stretching of the Achilles tendon and plantar fascia, weight loss, taping, arch support and heel lifts
  • Night splints
  • Ice Massage

 

 

What PTC can do for you…

  • Decrease initial pain and inflammation.
  • Identify biomechanical dysfunction.
  • Improve flexibility.
  • Strengthen the plantar fascia.
  • Return to full fitness.
  • Injury prevention.

Physical therapy includes myofascial release and scar tissue breakdown of the plantar fascia, and supervised stretching. A strengthening program for the calf muscles and small muscles of the foot is important. We will also use evidence based manual techniques to get you on the road to recovery.

Be aware that this may increase soreness initially, but persistence should be rewarding. Care should be taken to wear supportive and stable shoes. Patients should avoid open-back shoes, sandals, ‘flip-flops’, and any shoes without raised heels.

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