Plantar fasciitis
What is plantar fasciitis, how can you heal this painful condition?
What is your plantar fascia?
In our blog post ‘How Myofascial release and trigger point therapies can relieve your pain today!’ we explained about fascia, the connective tissue that holds together and in place your organs, blood vessels, nerve fibres, muscles, bones, ligaments, tendons and even your blood.
The plantar fascia is one of the thickest areas of fascia on the body. In healthy people, the fascial tissue is between 2.2 to 3.6 mm.
It attaches the heel bone to the base of the toes, supports the arch and absorbs the impact stress on the foot from walking or standing.
When the plantar fascia becomes inflamed it thickens causing heel pain. This is called plantar fasciitis.
Keep reading to learn more about this condition, what causes it and how to treat it.
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What is plantar fasciitis?
Plantar Fasciitis is one of the most common orthopedic issues and can affect one or both heals.
Over use, wear and tear or degeneration (planta fasciosis) can damage or leave small tears in the ligaments.
The thick band of fascia tissue becomes inflammed causing pain and stiffness in the heel. It also loses it’s elasticity and resllience and can be irritated by walking or running.
Both men and women between the ages of 40 and 70 and who live an active lifestyle are at the highest risk of developing plantar fasciitis.
Pregnant women, especially later in their pregnancy, are also often predisposed to suffering with plantar fasciitis.
How do you get plantar fasciitis?
10 reasons you may develop plantar fasciitis:
- You are a runner.
- You have increased your running or walking program.
- The shape or structure of your foot. eg. If you have high arches.
- You have gained significant weight or obese.
- Wearing shoes that do not support the foot. eg. Soft soles, high heals or with poor arch support.
- Your profession means that your are on your feet for long periods of a time.
- Your Achilles tendons attach your calf muscles to your heels and if they are tight they can be a risk to you developing plantar fasciitis.
- You have a unusual walk.
- Your foot position is atypical.
- You are between 40 and 70 years of age.
Although not common, medicual conditions such as lupus and rheumatoid arthritis can also be causes.
Care for your feet every week with our Essential Foot Release series!
What are the symptoms of plantar fasciitis?
Plantar fasciitis can come on slowly with a dull ache that can develop over time or suddenly, especially after stepping the wrong way on a stair or jumping and landing the wrong way.
The pain can be at the bottom of the heal and can radiate to the bottom mid-foot area.
People complain that the pain is usually worse after they have been sleeping, sitting or inactive for a period of a time and get up to take the first steps.
Prolonged activity can irritate plantar fasciitis, however most do not feel the pain until after they have stopped.
Climbing stairs can also be a challange when the heel is stiff.
People with fascia thicker than 4mm are considered to have plantar fasciitis.
How is plantar fasciitis diagnosed?
To diagnose plantar fasciitis your doctor or health practitioner will discuss with your any history of previous issues with your feet and do a physical examination.
They will check for:
- Tenderness
- Inflammation
- Balance and how you are walking.
- Where the pain is located.
- Muscle tone.
If needed they will ask you to have a ultrasonography (ultrasound) or magnetic resonance imaging (MRI) to check the thickness in the plantar fascia and any abnomal tissue.
5 myths about the causes of plantar fasciitis?
There are several myths about how plantar fasciitis is caused so let’s dismiss them!
- Health practitioners once thought that heel spurs caused the pain related to plantar fasciitis however this isn’t the case.
- Plantar fasciitis is heredity.
- You get plantar fasciitis from having flat feet.
- Plantar fasciitis is a torn foot muscle.
- That there is no cure for plantar fasciitis.
What are the treatment options to care for plantar fasciitis?
Treatments for plantar fasciitis can include easy to do home care that you can do yourself, alternatively you may need medication, therapy or surgery to relieve pain and repair the fascia.
Home treatments and care advice for plantar fasciitis
- Rest – It is important rest your the plantar fascia when it is inflammed or irritated. Do not to over exercise or stand for long periods. Elevate your feet when you can. If you need to exercise try cycling, Pilates or swimming.
- Stretch – Tight Achilles tensons and calf muscles can contribute to the pain caused by plantar fasciitis. Lightly stretching and releasing these areas can give you relief. Also, stretching the plantar fascia itself can help.
- Ice – Icing your plantar fascia will help with the inflammation and swelling. Use a frozen bottle of water and gently roll your foot on it for up to 10-15 minutes, 3 or 4 times a day, to get both a stretch and release at the same time!
- Anti-inflammatory medication – Taking a non-steriodal anti-inflammatory medication such as ibruprofen are recommended to relieve pain and inflammation. Please use only as directed by your pharmacist or doctor.
- Replace worn out foot wear, especially those used for exercise.
Aromoatherapy for plantar fasciitis inflammation
You may like to include aromatherapy oils into your treatment plan.
A 2010 study showed that aromatherapy oils contain Carvacrol (CV) which is a phenolic monoterpenoid.
Carvacrol possesses a wide range of bioactivities putatively useful for clinical applications such antimicrobial, antioxidant, anticancer and antiinflammatory activities.
The best essential oil to use is thyme. However you can also use clove, rose, eucalyptus, fennel, and bergamot.
Put a few drops in a carrier oil like almond oil, grapeseed oil or even olive oil and massage the area.
Note: If you are pregnant please consult your doctor before massaging with essential oils.
Physcial therapy and aids for plantar fasciitis
By adopting the care protocol we have just outlined you should have relief of symptoms in 6 to 8 weeks, but unfortunately with chronic plantar fasciitis it can take up to 12 months for your foot to go back to normal. If this is the case to help with the healing process your doctor or health care therapist might also suggest you try the following treatments and aids.
Physical therapy for plantar fasciitis at Studio Australia Barcelona
Our holistic approach to treating patients with plantar fasciitis means looking at the body as a whole.
We want to know if the person who is suffering with the condition feels pain when in bipedal posture.
By assessing their gait (pattern of walking) our Holistic Physiotherapist Aline Tisato is able ascetain any abnormalities.
The effect is that major biomechanical structures, in order to compensate the body discomfort, are going to be stressed and therefore muscle tone and fluid circulation are compromised.
In order to free up the biochemistry that repairs the body when inflammation occurs and to heal your plantar fasciitis, Aline uses her skills including:
- Myofascial Release on the spine and hip area
- Abdominal Acupuncture (distal points that benefit the foot)
- Local specific acupuncture points (calf, ankle and foot)
- Foot massage to release plantar fascia tightness
- Physiotherapy exercises for stretching and strengthening foot muscles
- Homework recommendations: foot workout, hydration, activity and rest
- Postural training to prevent relapses.
Braces, supports, night splints & orthodics
Your doctor or therapist may recommend, for a short period of time, that you support and isolate your foot while it heals.
Methods may include:
Braces – A boot cast to support and reduce sprain on the foot.
Supports – Canes and crutches to take the fulll weight off of your foot.
Night splints – Will lengthen the Achilles and plantar fascia while you sleep to promote stretching.
Orthodics – Custom made by a podatirist or off-the-shelf orthodics will distribute the weight on your foot more evenly.
Kinesiology tape – Used to support the foot and help reduce pain.
Surgical or medical proceedures for plantar fasciitis
Surgery
The option to offer surgery for plantar fasciitis is really seen as a last resort.
Surgery is only done:
- When plantar fasciitis is severe.
- You are unable to flex your foot or hold it in a neutral position (ie. 90-degree angle to the leg).
- It continues for more than 6 to 12 months.
One of the surgical procedures is a gastroncnemius recession.
This involves lengthening the calf muscle to allow increased motion in the ankle and flexibility in the foot which reduces the stress on the plantar fascia.
The other type of surgery is a plantar fascia release.
This proceedure is where the surgeon will cut part of the plantar fascia ligament to release the tension. It can include detaching the plantar fascia from the heel or making small incisions.
Injections
If your plantar fasciitis continues for more than 2 months a steriod injection into the belly of the ligament will help to relieve pain and inflammation.
However it’s important to note that steroid injections are a temporary solution and will only last a month.
Multiple shots are not recommended as they can weaken can the plantar fascia and possibly cause it to ruplture.
Extracorporeal shock wave therapy
Studies have shown that extracorporeal shock wave therapy using high energy sound waves to improve blood flow to the heel stimulate healing is effective for treating chronic plantar fasciitis.
Shock wave therapy is a non-invasive method of treating soft tissue injuries.
This therapy may be recommended as an alternative to surgery when all other treatment methods have been exhausted and the patient has been suffering with plantar fasciitis for more than 6 months.
The treatment is performed as an outpatient and you may need 2 -3 sessions depending on the severity of the condition.
References:
https://en.wikipedia.org/wiki/Plantar_fasciitis
https://www.hopkinsmedicine.org/health/conditions-and-diseases/plantar-fasciitis
https://www.healthline.com/health/plantar-fasciitis#treatment
https://orthopaedics360.com.au/blog/plantar-fasciitis-myths-misconceptions-dr-mike-smith/
https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/diagnosis-treatment/drc-20354851
https://pubmed.ncbi.nlm.nih.gov/29744941/
