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Plantar Fasciitis | The physio Fix

 Plantar fasciitis is a very commonly occurring painful foot condition. It refers to ' the inflammation of plantar fascia located on the sole of foot'. Plantar fascia is a thick band of tissue that originates from the medial tubercle of the calcaneus (heel bone), runs along the sole of the foot, and then inserts into the deep transverse metatarsal ligaments and fibrous flexor sheath of the toes. It provides support to the arch of the foot, aids the foot movement, and plays a vital role in weight-bearing. 

Female experiencing heel pain after exercise due to plantar fasciitis

CONTENTS

  1. Introduction
  2. Causes
  3. Symptoms
  4. Diagnosis & Treatment

CAUSES

As mentioned earlier, The term Plantar Fasciitis refers to " the inflammation and irritation of the plantar fascia ". This can happen due to multiple reasons out of which the most commonly occurring are overuse, repetitive stress, and mechanical abnormalities of the foot. This condition can affect people of all ages and fitness levels. However, a job that requires prolonged standing or having flat feet/high arches can make you prone to plantar fasciitis.
  • Obesity: excessive stress on the plantar fascia of the foot can lead to plantar fasciitis 
  • Flat feet, high arches, or abnormal gait pattern 
  • Sports activities involving high-impact movements or running
  • Improper footwear

SYMPTOMS

The leading symptom of plantar fasciitis is heel pain. It often feels like a sharp and stabbing pain in the heel that worsens with activity such as standing, walking, running, etc. Rest and warming up may provide temporary pain relief
Other symptoms that might accompany heel pain include stiffness, swelling, and tenderness. 

DIAGNOSIS

A thorough medical history and physical examination are usually considered enough to diagnose the condition. In physical examination, The doctor palpates the bottom of your foot to identify the areas of pain or tenderness and observes the sole of the foot for any signs of swelling or inflammation. However, in some cases, the doctor might perform a few tests to rule out plantar fasciitis. These tests may include: 
  • Windlass test: The patient stands on a stool and the healthcare professional passively dorsiflexes the big toe of the patient's foot. The presence of pain indicates a positive test. 
  • Imaging tests: X-ray, ultrasound, or MRI scan to confirm the diagnosis by visualizing the plantar fascia and specifying the areas of inflammation. 

TREATMENT

Plantar fasciitis is commonly treated with a combination of non-surgical options including rest, ice therapy, stretching, and pain-relieving medication. While, in some cases, surgical intervention may be necessary as the ultimate solution for persevering and severe pain. Some general yet effective treatment options include:

REST

You should avoid activities that may worsen the pain for a few days such as, prolonged standing, running, and other sports activities. Gradually, begin to increase the activity levels as the pain reduces. 

ICE THERAPY

Applying an ice pack to the heel for at least 15-20 minutes will result in a significant reduction in inflammation and lead to a speedy recovery. You can repeat this process several times a day for better results. How does ice therapy work?

STRETCHING EXERCISES

Regular stretching exercises will help improve flexibility, and strength and reduce pain. 
  • Calf stretch: Sit on the floor with your legs extended in front of you. Dorsiflex your foot while keeping your leg fully extended and knee straight. Use a towel to gently pull your foot towards you while keeping your knee straight. Hold the stretch for 15-30 seconds and then release. You should feel the stretch in your calf while performing it.
  • Plantar fascia stretch: Sit on the floor with your legs fully extended in front of you. Loop a towel around the ball of your foot and then gently pull it towards yourself.

PAIN RELIEVERS

NSAIDs i.e. Non-Steroidal Anti-Inflammatory Drugs such as ibuprofen or naproxen can help in reducing pain and inflammation.
You can also use orthotics to provide support to the foot or splints to keep the foot in a neutral position at night during sleep.

PHYSICAL THERAPY

A physical therapist can help in reducing pain and faster recovery of plantar fasciitis by providing specific exercises to improve flexibility and strengthen the calf muscles and foot. Physical therapy for such conditions may involve massage therapy to release tension in the foot and ankle, gait training, strengthening, and stretching exercises. 

SURGICAL TREATMENT

The cases that do not respond to conservative treatment options usually require surgery for their recovery. Surgical options for plantar fasciitis may include plantar fascia release or bone spur removal. 

In addition, maintaining a healthy weight, using proper footwear,, and incorporating stretching exercises in your routine can help reduce the stress on plantar fascia, prevent any further injury,, and maintain fitness. Swimming, cycling, yoga,, and other low-impact activities are advisable. 

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