Foot Pain: Plantar Fasciitis
Description
Plantar fasciitis is a condition, which involves pain in the heel. It occurs when the plantar fascia, a thin layer of tough tissue supporting the arch of the foot, becomes sore where it attaches to the heel. Under certain conditions, the plantar fascia can undergo excessive strain that results in micro trauma (tears) and inflammation. This inflammation causes the heel to hurt, feel hot, and sometimes even feel swollen.
Typically with plantar fasciitis, the pain is worse when first getting out of bed, or when getting up after sitting for a prolonged period of time. Usually, after walking a few steps, the pain will ease. In some people, the pain gets worse with prolonged standing or walking.
Causes
There are a number of possible causes of plantar fasciitis: walking for prolonged periods of time in shoes that do not give good support and/or do not fit well (especially if they are too small), tightness in the muscles of the foot and lower leg, improper athletic training, and/or anything that causes excess stress on the arch. People with low arches (flat feet) or high arches are at increased risk of developing plantar fasciitis.
In some cases, excessive stress on the plantar fascia over a long period of time can cause extra bone growth at the heel, which is known as a “heel spur”. Heel spurs may be present with plantar fasciitis, but not always. Likewise, the plantar fascia can be very sore, even though there are no heel spurs present. No treatment can make the bony growth of heel spurs go away, but the inflammation that causes the pain can be affectively treated in order to resolve the symptoms.
Treatment
The general rule with plantar fasciitis is the sooner you seek treatment, the sooner you will be better. Without treatment, symptoms can sometimes go on for 6 to 18 months or longer. Your physiotherapist will start you on a treatment program, which may include:
- Stretching exercises
- Manual therapy, which can include deep tissue massage
- Modalities such as therapeutic ultrasound, laser, shockwave therapy
- Taping the arch may be used to give support
- Advice on icing the heel, especially after exercise or prolonged walking, to reduce inflammation
- Advice on proper shoes and sizing for your particular foot type (for instance if you have flatter arches, a shoe with very good arch support may be recommended.)
- Advice on altering activities as necessary
- You may be advised on custom orthotics which are inserts made for your shoes that support your arch
