What is Plantar Fasciitis?
The plantar fascia is a dense fibrous band of connective tissue that originates from the medial heel of the foot and inserts on the bones in the forefoot.
Plantar Fascia
This tension band supports the medial arch of the foot and can assist in push-off when running and/or jumping. Plantar fasciitis ("itis" = inflammation) results from the biomechanical abuse of the plantar fascia leading to microtrauma and inflammation. It is often a chronic condition that may take months to resolve. Risk factors include: obesity, high impact training, pes cavus (high arch) and/or pes planus (flat feet).
Pes Planus
Clinical Signs and Symptoms
- Pain at the bottom of the foot near medial heel and arch
- Foot and/or heel pain with weight bearing (standing, walking)
- Foot and/or heel pain 1st thing in the morning when stepping out of bed
Treatments
- Podiatry (MD specializing in foot pathology) consult may lead to fitting of orthotics (supportive shoe inserts). Orthotics can be custom fabricated or purchased over the counter. Cam walker boot, worn during the day, and/or night splints, to keep tissues on stretch during the night, may also be helpful to manage foot pain
- Heel cups: Can be purchased over the counter. Inserts into your shoe to support and cushion the heel.
- Massage: to the calf and foot may help to increase circulation, decrease stiffness and help manage pain.
- Rest: Avoidance/Rest from activities that aggravate, especially high impact activities (running, jumping)
- Proper Footwear: Barefoot walking is usually discouraged. Wearing walking or running shoes outdoors may better support the arch of the foot. Slippers with arch support can be used indoors.
- NSAIDs: Non-steroidal anti-inflammatories over the counter or prescribed by MD can help to reduce foot/heel pain and inflammation.
- Ice: Frozen water bottle can be rolled under the bottom surface of the foot for an ice massage to manage foot pain.
- Physical therapy: Iontophoresis (electrical stimulation used to drive steroidal medication into the tissues); phonophoresis (ultrasound used to drive steroidal medication into the tissues); low dye taping; stretching; strengthening; and, manual therapy (joint mobilization, soft tissue mobilization, may be helpful to decrease pain and improve stability with walking.
Stretches
Calf and plantar fascia stretching in the relatively pain free range can be helpful to decrease stiffness and pain. To stretch calf, affected limb stays behind as in illustration with knee straight and heel flat on the floor. Gently lean forward until a stretch is felt in the lower leg, static hold for 20 second, 3-4 times.
Calf Stretch
To stretch the plantar fascia, gently pull the big toe upward until a stretch is felt in the arch of the foot, hold 10-20 second, 3-4 times.
Plantar Fascia
Avoid over stretching or latent increase in pain may result.
