Plantar Fasciitis

Do you have pain in your heels and through the arches of your feet first thing in the morning and after you have been sitting for a while? Or increasing heel pain as the day goes on?

The plantar fascia is a band of tissue that runs along the bottom of your foot with the main responsibility of the plantar fascia being to support the arch and absorb shock.

So what exactly is going-on to cause plantar fasciitis?

The pain experienced with plantar fasciitis is tensile strain on the fascia along with irritation and inflammation.

The common contributors to plantar fasciitis are: progressive flattening of the arch overtime

(flat footedness), a rigid high arch structure, lack of calf flexibility, being overweight, change in activity level, overuse (prolonged standing), and/or trauma.

Plantar fasciitis is widely seen in weight bearing occupations such as factory workers and nurses as well as in the athletic population.

(Typical) Symptoms

Plantar fasciitis typically presents itself as pain in your heels and through the arches of your feet when you take your first steps after getting out of bed or stand up after being seated for a long period of time. Typically the pain lessens and your feet become less stiff after you take a few steps and let your feet warm-up. Plantar fasciitis may also present as heel and arch pain that increase as the day goes on.


2 main concepts in treating plantar fasciitis:

  1. Decrease the inflammation (in the acute stages)

2. Address the cause of the condition

Custom-made orthotics made to each persons individual needs with a deep heel cup and designed to support your arch to off-load the stress placed on the plantar fascia. Excessive pronation (arch collapse) and high arches can play a role in developing plantar fasciitis. Orthotics are a proven treatment plan - altered foot biomechanics can increase the stress placed upon the plantar fascia. Orthotics can redistribute how the load is placed on the plantar fascia, addressing the cause. Excessive arch collapse or flattering of the arch lengthens the plantar fascia increasing tension in the plantar fascia and overloading the attachment of the plantar fascia to the heel bone. Supporting the arch puts 'slack' into the plantar fascia removing the extra tensile load.

Stretch! Ankle range of motion is important in not over stressing the plantar fascia - the most important being dorsiflexion (bringing your toes towards your shin). You want to aim for 15-degrees (past vertical 90-degrees) of available dorsiflexion with a straight knee. The ankle is required to dorsiflex for walking - with limited ankle dorsiflexion altered movement patterns place more stress upon the plantar fascia. By stretching your calf complex (soleus and gastrocnemius muscles) you can increase you calf flexibility. The tighter your calf muscles are the more stress is placed on your plantar fascia, and the looser your calf muscles are the less stress placed upon your plantar fascia.

Stretch especially before getting out of bed in the morning and after periods of inactivity. Perform foot circles (30 seconds in both directions) and pull your toes back towards your shin while keeping your leg straight before getting out of bed in the morning. This helps loosen up your calf muscles and plantar fascia that heal in a tightened position overnight.

Throughout the day perform calf stretches by placing your hands against a wall. Place your leg to be stretched behind you with your knee straight, heel flat and foot turned moderately inward to raise your arch. Gradually push your hips forward, towards the wall until you feel your best stretch (don’t overdo it).

Ulitize the bottom stair to stretch by standinng with the balls of your feet at the edge of a step, keep your knees straight and slowly let your heels drop until you feel a calf stretch.

Hold stretches for 30-60 seconds and then deepen the stretch by bending at the knee and hold for an additional 30 seconds.

Ice for 15-minutes at the end of the day or after activity to reduce inflammation and relieve pain — it's a natural analgesic so you won't feel the pain! You can even use a frozen water bottle like a rolling pin under your foot - the rolling will help stretch your foot muscles and break up adhesions.

Avoid barefoot walking — wear supportive footwear as much as possible; especially right when you get out of bed. An orthopaedic sandal makes a great indoor shoe providing support.

Correct Footwear - plantar fasciitis can also be caused by wearing old or inappropriate footwear. Replace footwear with a shoe appropriate for your biomechanics, foot type and sport. Sudden changes in heel height can change the load placed upon the plantar fascia - moving from a shoe with a 10-mm drop from heel to toe to 4-mm will increase the load on the plantar fascia. A Pedorthist can help recommend the correct shoe for you.

Self-massage – massage the plantar fascia to break up adhesions and stretch the tissue. Be sure to pull your toes back when doing this. You can even massage your plantar fascia by running your foot over a golf ball.

Strengthening the muscles in your feet can also help provide relief. Exercises such as foot doming and toe curls can help make your feet stronger.

Try a Straussburg sock (night-use) or FS6 compression sleeve

Shockwave Therapy and Platelet-Rich Plasma Therapy are also potentially effective treatment options.

If you are a runner, a change to your running gait can alter the load placed on the plantar fascia. Some may find an increase in running cadence to be beneficial in offloading the plantar fascia - by shortening your stride and landing closer to your centre of mass with your leg right underneath of you, as opposed to ahead of you and over striding.

Involve a variety of practitioners including pedorthists, massage therapists, physiotherapists, chiropractors, and osteopaths in your treatment plan.

#conditions #heelpain #plantarfasciitis #footpain #orthotics #injury