Do you ever wake up from a great dream, only to have the nightmare of shooting heel pain as soon as you put your foot on the ground? If so, you are probably familiar with plantar fasciitis. Plantar fasciitis is a common foot condition that causes significant pain and discomfort. In this blog, we will discuss the causes and symptoms of plantar fasciitis, as well as how performance physical therapy can help eliminate it for good.
What is Plantar Fasciitis?
The plantar fascia is a thick band of connective tissue that runs along the bottom of your foot, connecting your heel bone to your toes. It plays a crucial role in supporting the arch of your foot and absorbing shock when you walk or run. Plantar fasciitis occurs when this tissue becomes inflamed or irritated.
Causes of Plantar Fasciitis
Several factors can contribute to the development of plantar fasciitis. In most cases, it occurs when there has been a change in the amount or intensity of physical activity.
- Overuse or Excessive strain can happen with activities like running, walking long distances, or standing for prolonged periods. Continuous stress can lead to irritation and inflammation of the tissue
- Poor Foot Mechanics such as high arches, flat feet, or abnormal walking patterns can place extra strain on the plantar fascia.
- Improper Footwear – wearing shoes with inadequate arch support or inadequate cushion can increase the risk of developing plantar fasciitis.
- Excess body weight can put added pressure on the plantar fascia, making it more susceptible to injury
Symptoms of Plantar Fasciitis
The most common symptom of plantar fasciitis is heel pain. The pain is typically worse with the first steps in the morning or after periods of inactivity. The pain may improve with some movement, but return with prolonged standing or walking. Other common symptoms include:
- Stabbing, sharp pain at the bottom of the heel
- Pain that worsens over time
- Tenderness and swelling in the heel area
- Discomfort that may extend into the arch of the foot
Treatment for Plantar Fasciitis
Traditional Passive Treatments: Common initial treatment options for plantar fasciitis include rest from activity, ice, and orthotic devices to help support the feet in your shoes. When these are not enough to resolve the issue and/or the pain has lasted longer than 3 months, other traditional approaches include night splinting, ultrasound, and corticosteroid injections. However, although these can be effective in short term pain management, they do not often result in long term resolution of the problem.
As Performance Physical Therapists, we find the most successful treatment plan includes starting with an individualized assessment of the mobility and mechanical issues that likely led to the issue for your specific body (ie mobility of the ankle and foot joints, flexibility of the calf and plantar fascia, soft tissue restrictions in the muscles of the foot and calf, walking mechanics, and activity level/triggering activities). Then, we can build a specific program to help expedite the healing process and set up the tissue for long term success.
At RecoverRx Performance Physical Therapy, this can include tissue remodeling through manual massage, instrument assisted massage, dry needling, and education on self mobilization techniques to perform at home. These techniques have been shown to breakdown the adhesions that plague inflammatory tendon conditions and create new collagen fibers to replace the irregular collagen found in tendinosis, facilitating the repair process. (Health SA link) Then we would utilize stretching exercises and joint mobilization techniques to ensure your feet and ankles can move through full range of motion. And finally create a strength and stability program to help support the arch of your foot, and prepare your tissue to withstand the load and forces of daily life (walking, standing, running, etc).
We know that often, “Nothing will work unless you do.” By addressing the biomechanical issues and strengthening the tissue, we can help create an environment that not only supports healing but also helps prevent a return of symptoms.
Final Thoughts and Seeking Guidance
Plantar fasciitis is a common foot condition that can be painful but is typically manageable with proper care and treatment. While activity modification, taping, and use of supportive shoes throughout the day can help reduce the tissue irritation, if pain lasts longer than 2 weeks it is best to start a more active approach to treatment. Physical Therapy is a great place to start to learn specific techniques to mobilize the joints in the foot and ankle, learn proper stretching techniques for the calves and plantar fascia, and start a progressive strengthening program to support your foot for the demands of daily life, fitness, and competition. Therapists can also provide hands-on techniques to help relieve pain and promote tissue remodeling and repair. If you suspect you have plantar fasciitis, don’t hesitate to reach out so we can help you start on the road to recovery and pain relief!