By Nick Puleo, SPT
What is plantar fasciitis?
Your heel pain may be associated with plantar fasciitis, as it is the most prevalent condition of the foot and most common cause of heel pain! Plantar fasciitis is characterized as inflammation of the plantar fascia, a thick band of connective tissue that travels along the bottom of the foot from the heel bone to the toes and serves to support the arch of the foot. Plantar fasciitis is typically an overuse injury that is self limiting. Inflammation associated with plantar fasciitis can cause a stabbing, sharp pain that is relatively localized to the bottom of the foot on the heel bone. People suffering from plantar fasciitis often explain that their symptoms are worse with walking their first steps in the morning, or walking after any prolonged period of inactivity. Pain associated with plantar fasciitis usually subsides with activity.
Factors that increase the likelihood of developing plantar fasciitis
Age: most commonly affects individuals between the ages of 40-60.
Improper footwear: walking barefoot or wearing shoes that do not support the arch of your foot increase the chance of developing plantar fasciitis. Footwear that does not support the arch of the foot increases the amount of stress placed on the plantar fascia.
Foot biomechanics: flat feet result in a foot that has a stretched plantar fascia, which is not optimal for foot function. High arched feet create a shortened or tight plantar fascia, which results in a decreased ability to accept loads placed on the tissue.
Running: plantar fasciitis is the most common injury for runners.
Obesity: increased BMI places excessive loads on the plantar fascia, making it more susceptible to becoming irritated.
Jobs that require long periods of standing on your feet: The weight of your body in standing flattens the arch of the foot, increasing the amount of tension placed on the plantar fascia. Increased tension to this tissue can increase the likelihood of plantar fasciitis.
Multiple corticosteroid injections: corticosteroid injections are a common non-conservative treatment method for plantar fasciitis because they offer fast relief of pain. However, chronic corticosteroid injections decrease the extensibility and integrity of the plantar fascia, increasing the likelihood of a tear or rupture.
What should I do if I have plantar fasciitis?
See your PT!!
Physical therapists are trained to treat impairments associated with plantar fasciitis. Physical therapy for plantar fasciitis focuses on stretching of calf musculature, strengthening of the intrinsic foot muscles that support the arch of the foot, and improve joint mobility in the foot. PTs will use different manual techniques to address soft tissue and joint mobility restrictions to improve mobility of the foot. PT’s can also prescribe specific exercises that promote muscle strengthening and normalization of gait. Consult with your PT about trying orthotics. Orthotics can provide artificial support to the arch of the foot. In many cases, correcting the position of the foot will reduce symptoms associated with plantar fasciitis. Don’t neglect rest from activity! Although it may be difficult to heal (especially for runners), plantar fasciitis will often resolve with rest from intense activity. Plantar fasciitis is self limiting; rest will allow the inflammation of the plantar fascia to subside. Avoiding aggravating activities will speed up the recovery process.