What is Plantar Fasciitis?

The ‘plantar fascia’ is a supportive length of fibrous tissue that runs along the length of the sole of the foot, from the heel bone to the bones at the base of the toes. It covers the small muscles of the sole of the foot, supports the arch, and during walking and running, the plantar fascia tightens to help the foot act as a united lever, and allow you to push off with force in these activities.

With excess or repetitive load or force, this structure can develop microtears (small injury), particularly at its insertion onto the heel bone, where it is weakest. ‘Plantar fasciitis’ refers to localised inflammation and fibrosis of this structure, in response to the excess load it is exposed to. In some patients, the body’s response can be to lay down extra bone at this site of weakness,
referred to as a heel spur.

What are the causes?
This condition often occurs in older individuals, where the movement of the joints in the foot become decreased, due to normal age-related changes.
It can also occur for those individuals who do a lot of standing, walking or sporting activities, as in this case the plantar fascia is stressed by ‘overuse’.

Additional factors include:

    • Biomechanical abnormalities (the shape of your foot or leg bones and their muscle
      attachments)
    • Weak intrinsic foot musculature (the muscles that support the shape and movement of
      your foot)
    • Weak or tight calf muscles
    • Training errors (Type, intensity, frequency, form)
    • Inadequate footwear

Signs and Symptoms

    • Pain over the inside of the heel, that may radiate down the inside of the sole of the foot
    • Pain with activity – is most noticeable when taking the first few steps of the day (mostly in the morning) or after getting up from a sustained position
    • Tight calf muscles
    • Slight swelling around the heel

Treatment
The source of the pain as with any injury to soft tissue is caused by inflammation and a pain response. Treatment will vary depending on the individual requirements and severity of injury. After a thorough assessment with your physio, treatment may incorporate:

    • Reducing the aggravating factors
    • Addressing training errors
    • Stretching and strengthening (eccentric loading)
    • Taping
    • Soft tissue massage of the calf and plantar fascia and sole of foot muscles
    • Biomechanical/gait review
    • Footwear advice
    • Orthotic Prescription if required