Getting pain in your heel when you get up in the morning or on getting up after being sat down for a while? Drawing pain in the heel or arch of the foot after you’ve been stood up for a while? A burning pain in the foot at night? Pain that is triggered by exercise, improves on exercising and then comes back afterwards?
You may have Plantar Fasciitis.
What is it? The Plantar Fascia is a band of ligamentous-type tissue which joins the heel to the base of the toes. It is there to maintain and support the arch of the foot. Plantar Fasciitis is the term used to describe microtears, and subsequent inflammation, around the Plantar Fascia’s insertion into the calcaneus (heel bone) or along the arch. Microtearing is caused by excessive load on the plantar fasciitis. The pain perceived is secondary to the inflammation.
What causes it? This is variable from case to case, but some factors to consider include: - - age - gender - weight - time spent on your feet (either through work or training/exercise) - the surface you spend this time on (e.g. concrete) - poor footwear - biomechanics (e.g. pronation and tight calf muscles) - commencing a new activity Differential Diagnoses - arthritis (osteo or rheumatoid) - a calcaneal stress fracture - tarsal tunnel syndrome - Achille’s tendonitis - heel pad atrophy - osteomyelitis (rare) Management Treatment is centred on relieving the symptoms and identifying the underlying cause of the problem.
Relieving the Symptoms R E S T Easier said than done when we’re talking about the feet, but if you continue to weight-bear on (and therefore overload) the plantar fascia, the tissue will continue to tear and the inflammatory cycle continues.
Footwear Modification Chances are your footwear is not cushioned enough. You need shock absorbancy. A decent pair of trainers or a brand such as FitFlop® or adding a gel insole to your current footwear will help. Calf Stretches In most cases the calf muscles (gastrocnemius and soleus) are tight and effectively ‘pull’ on the plantar fasciitis, contributing to the microtear-effect around the heel and arch. It is important to stretch out these muscles to help relieve symptoms. A stretching information sheet is available here. Icing Use a frozen bottle of water to massage the bottom of the foot; roll the foot over the cool bottle for a few minutes as and when required. This will help to calm the inflammation and offer some pain relief. Massage Massaging the foot encourages blood to the area and can help soothe the pain and settle the inflammation. I recommend using a product such a Tiger Balm® or Voltarol® gel. The Voltarol® has the added benefit of being an anti-inflammatory product which will help to settle the inflammation caused by the microtears.
Orthotics Heel pads and arch supports may help to offer cushioning and correct over-pronation (‘rolling-in’) respectively. It is best to discuss these with a podiatrist to ensure you are not wasting your time (and money).
In Conclusion… You CAN rectify Plantar Fascitiis – but you should make sure you have the correct diagnosis before pursuing any management plan.