There are many causes of foot pain, gout, plantar fasciitis (heel pain), Morton’s neuroma, metatarsalgia and arthritis are just a few of the possibilities
Plantar fasciitis is an overuse injury that affects the plantar fascia on the sole of the foot. The plantar fascia is a tough, fibrous band of tissue that connects the heel bone to the base of the toes. The plantar fascia functions to support the arches of the foot. When the plantar fascia begins to degenerate or becomes inflamed, it is referred to as “Plantar Fasciitis”.
Signs & Symptoms
- Pain that is located on the sole of the foot, normally just in front of the heal bone
- Pain that is stabbing or burning in nature
- Pain is often worse in the morning
- Pain with prolonged walking
- Pain with prolonged standing
- Pain when stretching the sole of the foot
- Tenderness when touching the sole of the foot
Plantar fasciitis normally starts gradually with mild pain at the heel bone. Initially pain may only occur after rather than during activity. As the condition progresses pain will become more severe and it will start to limit activity.
It’s important to treat plantar fasciitis, and to do so quickly. It can easily become a chronic condition that result in patients being unable to continue their activities. Also foot pain will cause changes in your movement pattern, these changes can result in back, hip or/and knee pain.
Causes of Plantar Fasciitis
Plantar fasciitis is caused by tiny tears forming in the strong band of fascia (the plantar fascia) that supports the foot. These tiny tears occur after repeated stress and strain is applied to arches of the foot. Over-time inflammation and degeneration of the tissue results and this causes pain. The factors that can predispose somebody to developing plantar fasciitis include:
Too much physical activity
Plantar fasciitis is common in runners, walkers and in those who are on their feet all day. These activities lead to stress on the plantar fascia and surrounding tissues, especially if these activities are performed for prolonged periods, frequently or if you are unaccustomed to them.
Plantar fasciitis occurs more frequently in people with diabetes; this could be due to reduced neurovascular supply to the area.
Poor foot mechanics
Overpronating, having flatfeet or high arches can all result in extra stress and strain on the plantar fascia, which can lead to plantar fasciitis.
Being overweight puts extra strain on the arches of the feet.
As we age the arches of the feet begins to sag, putting increased stress on the plantar fascia.
Some rheumatic disorders can cause inflammation in the tendons and other soft-tissues of the body. In some cases this can include the plantar fascia resulting in plantar fasciitis.
What can I do to help prevent Plantar Fasciitis?
If you undertake sporting of physical activities always think “FITT”:
- F: Frequency – how often you exercise
- I: Intensity – how intense and physically demanding the exercise is
- T: Type – the type of exercise i.e. swim, run, weights etc…
- T: Time – how long you perform the exercise for
Try not to increase more than one of the above FITT at any one time. When you do increase, say the Frequency of your activity; wait at least 3-4 weeks before extending the length of Time you do the activity. This allows the body and its tissues time to adapt to the increased demand.
Treatment of Plantar Fasciitis
The plantar fascia heals slowly; therefore it may take 6 – 12 weeks for pain to go. However there are a number of things people can do to help speed up the recovery process.
It’s important to rest any injured area as much as possible. Activities that are aggravating to your condition should be avoided or limited as much as possible. Avoid running, long walks or standing, and extreme stretching of the sole of the foot. Gentle walking should not aggravate your condition and should help to maintain range of movement and strength.
Apply ice to the painful area for 10 minutes three times a day to relieve pain and inflammation. Avoid applying ice directly to the skin. One popular option is to freeze a small 100-200ml bottle of water and then roll/massage this along the sole of the foot pressing your foot into the bottle while it’s on the floor and moving your foot forwards and backwards.
As full rest is not always possible, taping can give good support to the plantar fascia allowing you to continue with work/sport. Tape applied to the foot serves to take the load off the plantar fascia, this allows the inflammation to reduce and healing to take place.
Your GP will normally prescribe a Nonsteroidal anti-inflammatory medication such as ibuprofen, to help reduce pain and inflammation.
Exercises are an important part in the rehabilitation process for plantar fasciitis, and also help to reduce recurrence. A home exercise programme to both strengthen and stretch the muscles of your lower leg and foot is important to ensure that full function returns.
FOOTWARE & ORTHOTICS
There are various opinions on footwear and shoe inserts. Some professionals will promote soft supportive shoes with inserts, while others believe that walking barefoot will allow normal foot biomechanics to return. This is individual for each patient and your osteopath or allied healthcare professional should discuss your options.
Osteopathy can help speed up the recovery from plantar fasciitis by:
- Increasing joint mobility with the foot and ankle
- Reducing muscular and fascial tension within the lower leg and foot
- A home exercise program
- Personalised advice on activity medication and footwear