The plantar fascia is a very thick band of tissue that connects the heel bone to the toes. This band of tissue under tension helps maintain the integrity of the main arch of the foot. Plantar Fasciitis is a common foot condition that causes heel pain and pain in the sole of the foot – it is often sore first thing in the morning or on standing after periods of inactivity. Often this pain can be very severe but the good news is that it is treatable by our Physios who have had specific training in the treatment of this condition.
Causes of Plantar Fasciitis
Plantar Fasciitis is inflammatory in nature and the key to successful treatment is to determine what is causing the inflammation and address this problem.
The most common cause of Plantar Fasciitis is due to problems with the biomechanics of the foot. The usual findings are a foot that ‘over pronates’, where the inner arch of the foot rolls over too much during walking and running. Pronation makes the foot unstable and flatten, which stretches the plantar fascia and puts its insertion in the heel bone under huge stress.
Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when one’s job requires long hours on the feet. Obesity may also contribute to plantar fasciitis.
Plantar Fasciitis is reasonably common in:
- Patients with a very mobile foot type
- Patients who wear unsupportive footwear
- Older patients, where the movement in the joints of the foot has become restricted and strain on the Plantar Fascia is increased.
- Patients, who do a lot of standing or walking.
- Patients, who are very active in sport and in particular running
It tends to be more common in females and in people who are overweight, but if you are a healthy young man, do not worry we see plenty of your type as well!
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Symptoms of Plantar Fasciitis
The symptoms of plantar fasciitis are:
- Foot pain over the inside / bottom of the heel
- Pain often radiates down the inside of the sole of the foot
- Pain that is usually worse in the mornings
- Pain that increases over a period of months
People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they’ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.
If pain is present on touching the affected area, and/or on stretching the Plantar Fascia, then it is likely that you have Plantar Fasciitis.
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Treatment of Plantar Fasciitis
The treatment of Plantar Fasciitis depends on both the cause and the symptoms being experienced by our patients. To arrive at an accurate diagnosis, our foot and ankle Chartered Physiotherapists will obtain your medical history and examine your foot. Throughout this process the physio will rule out all the possible causes for your heel pain other than plantar fasciitis.
The following treatment may be used:
Orthotics / Insoles – Where there are biomechanical cause to Plantar Fasciitis, our Physios will complete a full biomechanical assessment and Gait Scan to accurately determine the aetiology. Depending on the results, we may prescribe either off the shelf corrective insoles or customised orthotics, which we manufacture bespoke for you using our Gait Scan technology. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis. We are Ireland’s largest provider of Customised Orthotics and our team are specifically trained in treatment of Plantar Fasciitis. For full details on this service, click here
Inflammation reduction – Physiotherapy, may be used in conjunction with the above or as a standalone treatment to reduce local inflammation.
Mobilisation – Stiff joints around the foot and ankle can be treated using mobilisation, where our Physios gently moves the joints manually to remove the stiffness and restore the normal range of movement.
Taping and Strapping - Taping and strapping has been shown to be an effective treatment for Plantar Fasciitis. The tape supports the Plantar Fascia and removes some of the strain that can aggravate the condition.
Rest - In most sporting individuals the cause is overuse and the most important advice is to allow adequate rest, to take the strain off the Plantar Fascia and allow the affected tissues time to heal.
Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. Wearing supportive shoes, stretching, and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.
When Is Surgery Needed?
Although the majority of our patients with plantar fasciitis respond to our treatment, a small percentage of patients may require surgery. If we cannot correct the condition ourselves we will refer you to a Consultant, who will consider surgery. Your foot and ankle surgeon will discuss the surgical options with you and determine which approach would be most beneficial for you.
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What to do before you come into us?
We recommend that you come into see us as soon as you can, as leaving Plantar Fasciitis untreated can lead to further complications which ideally should be avoided. However, if you cannot see us immediately we recommend:
Stretching exercises Exercises that stretch out the calf muscles help ease pain and assist with recovery.
Avoid going barefoot When you walk without shoes, you put undue strain and stress on your plantar fascia.
Ice Putting an ice pack on your heel for 20 minutes several times a day helps reduce inflammation. Place a thin towel between the ice and your heel; do not apply ice directly to the skin.
Limit activities Cut down on extended physical activities to give your heel a rest.
Shoe modifications Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia.
For a full list of our Foot Related injuries please click here
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