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Physio & Treatment of Plantar Fasciitis

Plantar fasciitis is one of the most common types of foot pain. Plantar fasciitis develops when the connective tissue, which supports the arch of the foot, is torn, bruised or becomes inflamed. This connective tissue is called the plantar fascia. It is a thick, fibrous tissue running from the heel to the ball of the foot. It is there to maintain the position of bones and joints and helps with pushing off from the ground. Plantar fasciitis occurs due to overstretching, over shortening or excessive direct pressure to the tissue, which results in inflammation and pain.

Symptoms of Plantar Fasciitis

  • Pain in the heel or the sole of the foot:
    • when standing for long periods
    • after getting up from resting
    • after exercise (not so much during)
    • which gets worse with movement
  • Sharp pain in the foot
  • Swelling of the heel or sole of the foot

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Causes and Risk Factors for Plantar Fasciitis

Plantar fasciitis is caused by repeated overstretching or trauma. People who are very active are more likely to develop plantar fasciitis. This is due to the extra stress placed on the heel bone and attached tissue. Sports that tend to put extra stress in this area include ballet, running and aerobics. Other risk factors include poor foot, ankle and knee strength and movement control.

 

There are some medical conditions which increase the risk of plantar fasciitis. This includes arthritis and diabetes. Some types of arthritis may cause inflammation to the tissue, which can lead to plantar fasciitis. Also, people with diabetes are at a higher risk of developing this condition due to changes in circulation and the quality of the connective tissue.

 

Being overweight or obese is a risk factor for developing plantar fasciitis. This is due to the extra weight putting increased stress and strain on the plantar fascia. It is, however, only one factor and a strong foot and ankle can often counteract the additional stress associated with being overweight. Another risk factor which puts an increased load on the plantar fascia is working in occupations that require standing on your feet for long periods of time, particularly on hard surfaces. As the soft tissue of the plantar fascia, foot and ankle fatigue, it places passive stress on the plantar fascia. Incorrect footwear, hard surfaces or poor foot muscle endurance combined with long hours on the feet is often a recipe for foot arch pain.

 

Finally, being pregnant or elderly both increase the risk of developing plantar fasciitis. For those who are older, the arch of the foot can begin to sag. This places extra strain on the plantar fascia. As well as this, pregnancy can result in swelling and weight gain and may cause the tissue in the plantar fascia to relax, which may lead to plantar fasciitis.

Plantar Fasciitis Treatment

On a positive note, plantar fasciitis is very treatable, with about 90% of patients showing significant improvements within six to eight weeks, often less. A good quality Physio for plantar fasciitis will identify all the contributing factors to your pain and put in place strategies for helping you through the recovery process.

 

Physio treatment for plantar fasciitis requires a broad approach by the clinician. Some typical interventions might include ice therapy, home stretches, specific muscle strengthening, taping, foot orthotic prescription and exercise and lifestyle advice. Of greatest importance is to identify when there is weakness, lack of endurance or poor coordination in the area or the joints above.  

 

An experienced physiotherapist will thoroughly assess your condition to provide an accurate diagnosis and treatment plan. The aim of physio for treating plantar fasciitis is initially to reduce pain and begin to restore movement. Then the goal is to improve flexibility and strength while also addressing any biomechanical issues. The overall aim is to restore the patient’s ability to resume their pre-injury level of activity and minimise the risk of future episodes. 

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