Plantar Fasciitis: The Basics
The plantar fascia is a band of soft tissue that runs underneath the arch of the foot. Along with it comes one of the most common orthopaedic complaints: plantar fasciitis.
The role of this band of soft tissue is to hold your arch up and provide support, it acts like a tie-beam on a bridge. Throughout each step, the plantar fascia is activated, but it is under the most strain during the push-off phase of gait (this is when you propel forward at the end of each step).
At the heel of the foot, the plantar fascia has an attachment point known as the medial calcaneal tubercle; where many patients report plantar fascial pain. Often people experience heel pain as the plantar fascia tissue pulls on this attachment point.
Plantar fasciitis may begin as mild heel pain when you step out of bed in the morning, however it is likely to develop to a point where you are affected throughout the whole day.
Most people report the worst pain when getting up from a seated or lying position, which is a common characteristic of many soft tissue injuries. The heel pain often improves after a few steps hence why people tend to delay assessment.
Plantar fasciitis progresses over time and becomes so severe that the pain limits your ability to exercise, if at all. On some occasions the plantar fascia may develop a tear or rupture.
The key part of treatment is to address the heel pain as early as possible, in order to provide the best possible management plans. Early assessment allows your podiatrist to also eliminate other possible causes of your heel pain.
At TFC Podiatry, your initial appointment includes assessment of the above and your lifestyle to help best manage your pain on a day-to-day basis. On some occasions your Podiatrist may refer you for an ultrasound or x-ray in order to better understand your pain.
There are several risk factors which make you more likely to develop plantar fasciitis.
1. Calf tightness: Tightness in the calf muscle can cause an early heel rise which in turn places more load on the plantar fascia. Having tightness and/or trigger points in the gastrocnemius or soleus muscles (calf muscles) can place you at higher risk of developing plantar fasciitis.
2. Poor footwear: Footwear that does not provide adequate support or is not suitable for your foot posture. Different runners have different levels of correction, therefore it is important to choose the right shoe for your foot posture. Your podiatrist will be able to recommend an appropriate shoe after conducting a thorough biomechanical assessment.
3. Foot posture: Very high or low arches can place extra load on the plantar fascia and the surrounding structures.
4. Biomechanical factors: Foot and/or lower limb function whilst walking or running. This will all be assessed within your biomechanical assessment which involves a video gait analysis. Your Podiatrist will view you walking and discuss the findings with you.
5. Training errors: This can relate to increasing exercise levels too quickly. For example: inadequate training surfaces, incorrect technique etc.