Plantar fasciitis is an inflammation of the thick band of fascial tissue that connects the heel bone to the toes on the sole (plantar aspect) of the foot.
Plantar fasciitis is most common in runners particularly those who run on hard surfaces but also occurs in people who have to stand for long periods of time; those who wear poor footwear, such as shoes with little cushioning or arch support; people who pronate as the stand or walk; sudden weight gain, such as pregnancy; tightness, overuse or poor biomechanics in the calf and Achilles tendon.
Symptoms include a sharp “stabbing” pain in the heel on standing or walking, particularly in the morning or after long periods of sitting, a “burning” horseshoe ring of pain in the back of the heel, and tension in the Achilles tendon and the calf, all leading to limping while walking. The pain is likely to ease on movement throughout the day.
One of the most common foot complaints it effects 10% of people at some time during their life. While men can get plantar fasciitis, it’s more commonly reported in women, those with very high or low foot arches, pregnant women and those with poor biomechanics while walking or running.
A physiotherapist or podiatrist can make a diagnosis based on your symptoms, although if it has been present for a long period of time (6 months or more), a bone spur may have developed and will require an ultrasound for diagnosis.
Plantar fasciitis is considered a chronic issue and should be treated as soon as possible. The longer it goes on for, the worse it will be come and the harder it will be to treat.
A combination of different treatments may help;
1. Rest- ease off the running and switch to swimming or a low impact exercise to rest the feet;
2. icing the sole of the foot and elevation at the end of the day will help ease the inflammation – keep a bottle of water in the freezer for rolling on the bottom of the foot;
3. wearing appropriate footwear such as shoes with good cushioning and appropriate arch supports – be fitted for running shoes that support your arch and cushion your heel, put away the high heels and switch to comfortable flats, orthotic supports from a podiatrist or heel pads inside shoes can also help ease the pain;
4. stretching to the calves and hamstrings, before and after exercise or a day on your feet, rolling the sole of the foot over a ball to stretch the fascia are all good at home treatments;
5. massage, acupuncture and electro and dry-needling are very effective treatment options.
While needling the sensitive areas of the foot can be a daunting prospect there is good evidence it can be used as a good alternative option before proceeding to more invasive therapies of plantar fasciitis.
If the condition goes on untreated, it can lead to complications such as spurs in the heel and may require more invasive treatments such as steroid injections, shockwave therapy or surgery.
There are certain things that you can do to try to prevent plantar fasciitis, especially if you have had it before. These include:
• being fitted for, and regularly updating training shoes used for running or walking;
• wearing shoes with good cushioning in the heels and appropriate arch support;
• reducing body weight, not always an easy option but it can take the pressure off the bottom of our feet;
• stretching the plantar fascia and Achilles tendon, especially before exercise;
• avoiding exercising or standing on hard surfaces.
