Getting up out of bed giving you a pain in the heel?
Feet stiff after sitting for awhile?
This could mean you have plantar fasciitis.
What is the plantar fascia?
The plantar fascia is a strong, dense structure located at the base of the foot and runs from the heel bone to the base of the toe bones at the ball of the foot. The role of the plantar fascia is to assist with weight and force distribution through the foot when a person walks, runs or jumps.
What is plantar fasciitis?
Plantar fasciitis is a painful condition of the heel of the foot. In plantar fasciitis, the plantar facia becomes irritated and ultimately thickens. This usually occurs after a period of increased activity (starting a new training regime), during/after pregnancy or after stopping an exercise program.
What symptoms might you experience?
- Sharp, stabbing or burning pain at the heel.
- Pain that is usually at its worst in the morning when taking your first steps.
- Pain with walking after prolonged sitting or standing.
- Pain immediately following intense exercise.
There are a number of risk factors that increase your likelihood of developing plantar fasciitis. These include:
- Age: People between 40-70 years have a greater risk.
- Females are at greater risk than males.
- Pregnancy: Females often develop symptoms of plantar fasciitis during pregnancy.
- Structural factors: People with higher arches, flat feet or tight achilles tendon or calf muscle are at increased risk.
What can physiotherapy do?
Treatment for plantar fasciitis is dependent on the impairments found during an objective assessment.
Treatment generally focuses on strength and flexibility. Strengthening of the foot muscles and calf are shown to improve symptoms and function. Many people with plantar fasciitis also have weakness of the hips and therefore, strengthening the muscles of the hip can also play a major role in biomechanics and can alleviate the stress placed on the feet when walking, running or jumping. Although exercise is the go-to for treating plantar fasciitis, other treatment options such as taping, joint mobilisations, massage and shock wave therapy can supplement exercise along the way to help alleviate symptoms and improve function.
Our physiotherapists take their clients through a program which generally consists of a tendon loading program. The aim of this program is to restore the tendon to its pre-injury size, function and to reduce pain. This is then supplemented with mobility, strength and other functional rehab exercises.
Now. The BIG question surrounding this injury….
“Should I get orthotics?”
Orthotics have been a controversial topic for many years now. Although there are many cases when orthotics may be right for many people, this is not the case with everybody (most people in fact). Generally, people with plantar fasciitis show weakness in their calf muscle, foot muscles and hip muscles. Therefore, strengthening of these muscles should be the first line of treatment.
Often, people with plantar fasciitis have a very stiff midfoot. This can be very painful and a factor as to why plantar fasciitis has developed. Although our feet must handle the force of the entire body, research is showing that our foot should not be stiff. Instead, it should have movement through the middle of the foot.
This makes sense.
If the rest of our body shouldn’t be stiff then why should our feet be?
If a person already has a stiff midfoot, an orthotic would only make it stiffer. Yes, orthotics are usually given to those with flat feet to support their arches.We believe people would be much better off strengthening the muscles of the feet and supporting their own arches. Remember, most people with plantar fasciitis have weak foot muscles. If an orthotic is worn, these muscles do not need to be activated to support the arches and will only get weaker. Therefore, even though an orthotic may help to relieve some pain, it is not fixing the underlying issue.
It’s only sticking a band-aid over a crack in the wall.
As mentioned earlier, yes, orthotics may be necessary in some case. But having one fitted immediately is not the way to go. Instead, focus on improving strength, mobility and biomechanics of the lower body which has been shown to be an effective treatment method for plantar fasciitis.
Need more help with your plantar fasciitis? Check out our new E-Book HERE
Make sure you reach out and keep your eyes peeled on our Instagram and Facebook page this month as we will be giving you a tonne of information around this injury.
Written by Nicholas Dimos (Physiotherapist)