Plantar Fasciitis

What is Plantar Fascia?

The plantar fascia is a long, fibrous band stretching from your calcaneus (heel bone) in one solid band...

...and runs up the arch where it separates to join your toes (Refer to Figure 1).

The Plantar Fascia maintains your longitudinal arch integrity and enables mobility.

What is the Plantar Fascia

Figure 1: Plantar Fascia (WebMD)

What is the Plantar Fasciitis?

Plantar Fasciitis is inflammation of the plantar fascia.

This occurs when the Plantar Fascia is overused and develops small tears (Refer to Figure 2).

Plantar Fasciitis is one of the most common causes of foot pain.​

What is the Plantar Fasciitis

Figure 2: Image of Plantar Fasciitis (Moreton Hall Health Club)

Why does it Hurt more in the Morning?

The first few steps in the morning are usually the worst...

...this is because the Plantar Fascia relaxes overnight when you are not weight bearing,

then when you stand up, your longitudinal arch expands and your Plantar Fascia stretches.

If your Plantar Fascia is inflamed prior to rising,

it will hurt more when it becomes stretched (first few steps) until it warms up.

Signs and Symptoms of Plantar Fasciitis

Figure 3: Feeling of Discomfort (Lynn Mosher)

Signs and Symptoms of Plantar Fasciitis

Unidentifiable Discomfort

You may feel like you have a pebble in your shoe...

...or that your sock is creeping down your foot inside your shoe;

yet when you take your shoe off to check there is nothing there.(Refer to Figure 3)

Morning Pain

A classic sign of Plantar Fasciitis.

Upon rising, you feel significant arch and/or heel pain, which subsides after the first few steps

...and may return when you sit (maybe for lunch or to drive somewhere) then stand up again.

Advanced Plantar Fasciitis

You suffer morning pain (described above) only the pain worsens as the day progresses and there is a throbbing in your arch

or heel even in bed at night or upon rest.

(this throbbing pain is due to the plantar Fascia returning to normal length when weight is off your feet).

Causes of Plantar Fasciitis

Tight Calf Muscles

People with tight calf muscles (equinis) tend to be more prone to Plantar Fasciitis.

This is because the ankle is required to dorsiflex (allow the foot to move back towards the leg) at least 10 degrees for normal gait (walking).

When you have tight calf muscles the mid foot is required to twist to enable your heel to contact the ground during gait, thus putting more stain and stretch on the plantar fascia.

Pregnancy

In the later stages of pregnancy due to weight gain, fluid retention, the shift in your centre of gravity and postural changes your feet flatten to allow a wider stance for balance.

Your ligaments begin to soften and lax due to the body preparing to give birth.

All this extra weight and ligament laxity can cause added strain on the plantar fascia resulting in Plantar Fasciitis.

Causes of Plantar Fasciitis

Figure 4: Overpronation (Best Walking Shoes)

Poor Biomechanics

- Heavy heel strike due to increased, repetitive force on the heel.

- Overpronation as this forces the plantar fascia to lengthen and twist. (Refer to Figure 4)

- Long Distance Runners due to sudden repetitive heel strike (runners heel)

- High Arches can cause plantar fasciitis as well this is because of a tight plantar fascia continually pulling on the heel.

Obesity

Due to additional weight putting strain on the natural foot structure.

Poorly fitting shoes or Shoe Choices

- Flat shoes with no heel raise put strain on the Achilles Tendon and Calf muscles thus adding strain to the Plantar Fascia.

- Old worn shoes due to lack of support causing ankle rolling

- High Heels which encourage shortened calf muscles when worn for prolonged periods (Refer to Figure 5).

Therefore,

if you are going from wearing high heels into flat shoes or even runners...

...you are putting your calf muscles under strain and thus causing twisting and stretching of the plantar fascia.

Foot in High Heel

Figure 5: Foot in High Heel (Hugh Turvey)

Treatment for Plantar Fasciitis

The treatment you choose is always dependent on the severity and cause of your Plantar Fasciitis.

It is best to discuss the treatment appropriate for your individual needs with your podiatrist.1

- Gentle Stretching of the Plantar Fascia

This can be achieved by rolling a tennis ball or spikey ball under the three individual areas of the foot (toes, arch, heel) then backwards and forwardsunder the whole foot.

- Calf Muscle Stretching

This can relieve the Plantar Fascia by removing the pull of the Achilles tendon on the heel thus removing strain on the Plantar Fascia.

- Soft Tissue Mobilisation 

When performed correctly increases the muscle length thus increasing (ankle) joint range of motion (Refer to Figure 6).

Soft Tissue Mobilisation

Figure 6: Soft Tissue Mobilisation (Total Foot Health)

- Strapping

For added arch support and to temporarily correct abnormal biomechanics.

- Dry Needling (Accupuncture)

Assists in removing inflammation.

- Orthotic Therapy

A Customised Orthotic provided by your podiatrist should correct abnormal biomechanics when worn in the right shoe.

Did you know?

that customised Orthotics specific for Plantar Fasciitis supplied at Erica Dash Podiatry

correct abnormal biomechanics...

...as well as cushion your painful heel (Refer to Figure 7).

Orthotic Therapy

Figure 7: Orthotic Therapy (Precision Podiatry UK)

Article by Erica Dash

Erica started Erica Dash Podiatry in 1993 due to the need of a family friendly podiatry business on the Central Coast, NSW.

Erica is focus driven with a great interest in children and biomechanics.

She also welcomes patients of any age into her (state of the art) practice with an emphasis on family footcare.

Erica Dash Podiatry

Leaders in lower limb care embracing the whole family…