Plantar Fasciitis: Common Causes, Symptoms & Rehabilitation Options
Plantar Fasciitis is a common condition that affects the foot and heel. Unsurprisingly the specific structure that is damaged or injured in Plantar Fasciitis is referred to as the Plantar Fascia. The plantar fascia is a thick, web-like ligament that extends from the heel to the toes. It’s major responsibility is to provide support to the arch of the foot as well as assist with walking. Plantar fasciitis is one of the most common orthopedic complaints seen in musculoskeletal therapy clinics. Normally, this broad ligament acts like a shock absorber however too much pressure on your feet can damage or tear the ligament. This process leads to the fascia becoming inflamed and subsequently being uncomfortable and painful during activity.
WHAT ARE THE TYPICAL CAUSES OF PLANTAR FASCIITIS?
Plantar fasciitis is usually the result of an overload or repetitive type stress of the plantar fascia. Typically this is seen in athletes, runners, sports players or those with foot and arch disorders. The following factors which are listed below are a fantastic summary of the common causes of plantar fasciits:
- Foot and arch disorders such as high arch, flat feet, over pronation and supination
- Excessive activities including running or plyometric type activities
- Individuals who commence a brand new activity or are unaccustomed to particular exercise
- Obesity may also be a risk factor as it places additional stress on the lower limb and kinetic chain
- Weight and fluid gain associated with pregnancy
- Poor or inappropriate footwear
PLANTAR FASCIITIS SYMPTOMS
Individuals suffering from plantar fasciitis usually present with symptoms including a throbbing or piercing type pain that occurs during walking or exercise. Pain typically diminishes with rest. Other signs that you may be experiencing plantar fasciitis is that the sole of your foot may be tender to touch and demonstrate signs of inflammation such as redness, heat and swelling.
HOW IS PLANTAR FASCIITIS DIAGNOSED?
It is important for your treating practitioner to rule out other possible differential diagnoses before commencing management. This means a comprehensive lower limb, foot and ankle examination is paramount. During this examination you will receive:
- Review of your medical and health history. Typical questions that you may be asked include:
- How did the injury occur?
- How long have you been suffering with this type of pain?
- Have you experienced this previously? If so, what management (if any) did you seek?
- Can you describe the location and quality of pain?
- How severe is that pain?
- Physical examination which includes palpation of the foot and ankle, muscle testing to assess symmetry and strength, range of motion assessment of the foot and ankle complex as well as orthopaedic and neurological tests as clinically required
- Referral for imaging may be clinically indicated to assist your practitioner in formulating an appropriate diagnosis and therefore management plan. Such images may include X-ray (to rule out heel spur), Ultrasound, MRI or CT
PLANTAR FASCIITIS TREATMENT
While plantar fasciitis can sometimes be a rather difficult condition to manage majority of clients see enormous benefit from conservative management such as Chiropractic and Physiotherapy treatment.
Chiropractic & Physiotherapy
Physical therapy will be aimed at reducing pain as quickly as possible and assisting return to normal activity.
- Mobilization of the foot and ankle bones to improve lower limb biomechanics
- Soft tissue massage to the plantar fascia to reduce spasm, tightness and pain
- Physiological therapeutics such as Ultrasound, Shockwave therapy and low level laser treatment to assist with reducing inflammation
- Devices such as orthotics, taping and braces may be recommended to assist your recovery
WHAT DOES THE RESEARCH TELL US?
- There are a variety of treatment options which exist for managing Plantar Fasciitis including rest, stretching, strengthening, change of shoes, arch supports, orthotics, night splints, anti-inflammatory agents and surgery. Usually, plantar fasciitis can be treated successfully by tailoring treatment to an individual’s risk factors and preferences. Young, C. (2001). Treatment of plantar fasciitis. American Family Physician, 63(3); 477 – 478
- Foot orthoses produce small short-term benefits in function and may also produce small reductions in pain for people with plantar fasciitis. Long term benefit was not demonstrated. Landorf, K. (2006). Effectiveness of foot orthoses to treat plantar fasciitis: A randomized trial. JAMA, 166(12); 1305 – 1310