Plantar Fasciitis – Causes, Symptoms and Treatment
Plantar fasciitis is one of the most common causes of foot pain which can lead to difficulty with walking and weightbearing activities. The plantar fascia is located at the bottom of your foot which runs from your heel to your toes. It supports the bottom of your foot and acts as a shock absorber when you walk, run or jump. Click on this link for more information on anatomy of the plantar fascia
Plantar fasciitis is more prevalent in certain populations, for example, people who are overweight or who have a fallen arch (pes planus). It can also be more common in people who are more active like runners or dancers. Another example of individuals who may get pain from plantar fasciitis are people who are on their feet all day like chefs or teachers.
Symptoms
For people who present with this painful condition often the first step in the morning causes a stabbing intense pain which can be located at the heel or the mid-foot area. As the body begins to warm up the foot pain can subside but may return later in the day after long periods of standing, walking, or sitting. The pain can be described as dull or sharp or a burning ache at the bottom of the foot. People generally do not feel pain during sport or other activities, but after they stop the inflammation and pain can become more prevalent.
Causes
The plantar fascia starts at your heel and finishes at your toes, where it supports the underpart of your foot and is very tough. Over time tension and stress on the fascia can cause microtears and inflammation which in turn causes pain. Eventually the pain intensifies to a point where it is difficult to do regular activities like weight-bearing or walking.
Risk Factors
- Activity: certain types of sporting activities can put a lot of stress and strain on the plantar fascia leading to microtears and inflammation, for example, running, gymnastics or dancing.
- Age: if you are between the age of 40-60 years you are more at risk. However, please be aware the pain in for foot from this condition can appear at any age.
- Biomechanics: if you have a flat foot it can lead to a stress and pressure on the bottom of the foot which eventually leads to pain; the same applies for high arches.
- Occupational: people who are on their feet all day as part of their livelihood are more at risk to developing plantar fasciitis.
- Overweight: if you carry more weight it will put more pressure on the plantar fascia which can lead to pain and inflammation.
Diagnosis
Physiotherapy at Woodbridge will conduct a thorough physical assessment to identify the cause of your foot pain. It is a condition that is easily diagnosed at your physiotherapy clinic, so it is not necessary to get an ultrasound or xray. Our physiotherapy clinic is conveniently located in Woodbridge, Vaughan and also provides treatment for the surrounding areas of Maple and Concord.
Heel Spur vs Plantar Fasciitis
A heel spur is a natural build up of calcium on the underside of your heel. Quite often they are painless but on occasion they can cause pain which is remarkably like plantar fasciitis. Treatments for heel spurs are the same as plantar fasciitis so your therapist at Physiotherapy at Woodbridge will guide you on this. Click here for more info on heel spurs
Treatment
Conservative measures are the first choice which means physiotherapy as a pose to pharmacological or surgical treatments.
- Activity modification: relative rest from activities that are contributing to your pain. This may include sport or standing for long periods
- Dry Needling: this can be a quick and effective treatment to give you pain relief. Click here
- Education: your physiotherapist will give you some background on the condition that is causing your pain. He/she will also guide you on activity modification, stretching, strengthening and balance exercises
- Ice: this can be a relieving modality when applied to the bottom of your foot particularly at the end of a long day
- Laser therapy: this can be slower than shockwave therapy but less painful Bioflex Laser Therapy. Click here
- Massage: deep frictional soft tissue work to the bottom of your foot and calf area can help to take the pressure off the plantar fascia
- Orthotics: shoe insoles to support the arches of your feet are sometimes critical in long term relief from pain
- Taping: support to the arch can give people quick and effective pain relief
- If conservative management does not work then sometimes medical based treatments may be indicated by your family doctor which may include:
- Injections: steroidal medications can provide temporary relief to pain
- Medication: to decrease pain and inflammation
- Surgery: this is rare for this condition and is obviously a last resort
Tips for home remedies
- If you are into athletics make sure to change your footwear within a timely fashion (do not wear down your running shoes)
- If you find a certain activity is provoking your pain, try changing something that will decrease the pressure on your feet. For example, instead of running try cycling or swimming
- Maintain a health weight
- Use ice to decrease the inflammation and relieve pain
- Wear good supportive footwear and if necessary, talk to your physio about orthotics
- Stretch your calf muscle and arches
