What you need to know about Plantar Fasciitis

Plantar fasciitis is a common cause of heel and foot pain in adults of all ages. It is due to the inflammation (“-itis”) of the plantar fascia. The plantar fascia is a very thick band of ligament and connective tissue that is found on the sole of the foot.

Plantar fasciitis often affects the sedentary or athletic populations, or after an injury in the ankle, or from an underlying heel or foot condition. Although plantar fasciitis affects millions of people are year, it is often resolved with conservative treatment.

People who suffer with plantar fasciitis may present with:

• Heel pain with their first steps in the morning,
• Heel pain after prolonged sitting or at the start of a walk or run.
  • Pain may feel like a stone in your shoe or a sharp, stabbing pain in the sole of the foot.
  • A sharp pain is often noted when touching the inside portion of the heel on the sole of the foot.’

Risk factors and causes of plantar fasciitis can include:

• Excessive rolling in of your feet (foot pronation),
• Excessive running,
• High arches in the feet,
• Leg length differences (ie, one leg longer/shorter than the other) which places excess strain on one or both feet,
• Obesity or sudden weight gain,
• Prolonged standing or walking,
• Sedentary lifestyle,
• Tightness of calf muscles and small foot muscles,
• Heel spurs,
• Ankle sprains causing altered foot biomechanics and hence strain and inflammation on the plantar fascia which has become weak and continually loaded,
• Pregnancy,
• Poor shoes with no support.

Osteopathic treatment can be a helpful and conservative approach for plantar fasciitis.

Your Osteopath will primarily diagnose your plantar fasciitis by history taking, wherein they will ask numerous questions about your complaint which helps break down why you may have developed the symptoms and pain in the first place.

A physical examination will also occur and this may involve looking at the biomechanics of the lower limbs, including lower back, hips, pelvis, knees, ankles, and of course the feet! This includes joints, muscles, ligaments, tendons and associated connective tissue.

Imaging such as ultrasound, x-ray and MRI is rarely needed for the initial diagnosis of plantar fasciitis but can be used to rule out other heel, foot, connective tissue or joint problems that could be contributing to the plantar fasciitis. Once your diagnosis has been made and the causative factor has been identified your osteopath will be able to create a treatment plan for you. In the initial stages of plantar fasciitis your osteopath will discuss management strategies for you.

These may include:

• Rest,
• Activity modification,
• Ice,
• Anti-inflammatories – prescribed by your GP and/or consultation with your pharmacist,
• Stretching and/or strengthening exercises.

Your osteopath will also perform hands on treatment to assist in the more speedy recovery and future prevention of your plantar fasciitis. The approach will vary depending on what your causative factor is.

Hands on treatment of the feet, calves, lower legs, tights, hips and lower back can include:

• Massage to release tight muscles,
• Articulation to mobilise joints that may be stiff,
• Ensuring optimal function in your knee and hip so as to avoid any poor loading into the foot,
• Dry needling,
• Muscle strength and mobility work,
• Myofascial release work.

Other treatment options can include:

• Corticosteroid injections,
• Pilates for strength and mobility work in the feet and body,
• Podiatry assessment for orthotics or shoe inserts,
• Night splinting,
• Taping of feet and arches for support.

References: 

http://www.aafp.org/afp/2011/0915/p676.pdf

https://www.webmd.com/a-to-z-guides/tc/plantar-fasciitis-topic-overview#1

https://www.healthdirect.gov.au/plantar-fasciitis

http://sma.org.au/resources-advice/injury-fact-sheets/plantar-fasciitis/