Plantar Foot Pain - Plantar Fasciitis

Plantar Fasciitis

What is it?

Plantar fasciitis, now commonly referred to as plantar fasciopathy, is one of the most common causes of heel or plantar pain. This condition occurs when load on the plantar aponeurosis exceeds its tolerance and results in aggravation / irritation of the tissue. This tissue acts to support the arch of the foot, and as a result is subject to significant stress with weight bearing activity.

 

Symptoms commonly associated with Plantar Fasciitis

Symptoms associated with Plantar Fasciitis include (but are not limited to):

  • Heel pain and pain in the arch of the foot
  • Heel pain that is often at its worst first with the first  few steps in the morning or after rest
  • Symptom onset that is commonly associated with long periods of weight bearing or sudden changes in weight bearing or activity
  • Heel pain that is often described as sharp
  • Symptoms that often “warm up” during exercise and feels worse after exercise
  • Often tender on palpation, particularly at the fascia’s insertion onto your heel 

Contributing Factors associated with Plantar Fasciitis

MODIFIABLE RISK FACTORS

– BMI

– Foot posture (arch height and rearfoot pronation)

– Weak intrinsic muscles of the foot

– Inadequate proprioception

– Reduced dorsiflexion range of motion

– Reduced hamstring length

– Midfoot joint stiffness and reduced 1st MTPJ range of motion

– Loading/gait mechanics including rapid pronation

– Proximal strength and control

– Fatigue 

– Total activity load

– Change in activity/load

– Sport

– Surface

– Footwear 

– Running technique

– Life load/occupation (incidental exercise)

NON-MODIFIABLE RISK FACTORS

– Age 

– Foot posture (some aspects of foot posture are modifiable)

Considerations in the management of Plantar Fasciitis

SHORT TERM

DIAGNOSE

Diagnosis is a vital part of managing any injury. Not only is it important to determine which structures are responsible for your symptoms, but why they have become symptomatic. Addressing the ‘why’ will ensure adequate recovery and prevention of future injury. 

REHABILITATION

A rehabilitation program that targets the key contributing factors will fast track your return to pain free activity, and prevent future injuries. Your physio will design a program specific to you and your sport, for a successful return.

SOFT TISSUE TECHNIQUES AND DRY NEEDLING

Can be beneficial in addressing muscle function and joint position.

FOOTWEAR

Your physio will determine if footwear is a contributing factor, and may work with other health professionals such as podiatrists to address it properly. Taping techniques may also provide symptomatic relief in the short term.

REST AND LOAD MANAGEMENT

Initial rest from aggravating factors is important to reduce the inflammatory/stress response of affected tissues. Your physio will guide your return to sport/activity to limit the risk of aggravation that can slow rehab progress.

 

LONG TERM

REFERRAL

You may be referred to other health professionals such as podiatrists to assist in the management of your plantar foot pain.

SHOCKWAVE

There is some evidence for the use of shockwave in more persistent presentations of plantar pain.

STRENGTHENING

A progression of strengthening to a gym environment to address lower limb biomechanics and your loading profile may be required to ensure you can return to activity at your desired level.

 

SUMMARY

If you have any questions about plantar fasciitis or heel pain, please don’t hesitate to contact us (03) 5229 3911 OR email us at info@theinjuryclinic.com.au to book a consultation with one of our Geelong physiotherapists.

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