Yes, we do. Out of a number of foot problems that we see, plantar fasciitis is a relatively common problem that Physios treat. Conservative treatment done by physios has a high success rate, even though it may take a few weeks or months to improve. The healing time is dependent on each person’s circumstances, as well as their commitment to the prescribed treatment plan.
What is plantar fasciitis?
The plantar fascia is a thick ligament that connects your heel to the front of your foot. It helps to support your arch and the muscles of your foot and acts as a shock absorber. These ligaments experience a lot of pressure and load on a daily basis. Plantar Fasciitis occurs when there are small tears and/or inflammation in the plantar fascia. It can affect anyone, but there are a few factors that make you slightly more susceptible to this than others. These factors include:
- It is slightly more common in women than men.
- Pregnant women can experience this.
- Being overweight or obese. The extra weight adds pressure to your feet.
- Long distance running or other high impact sports including dancing. The repetitive high impact resulting from these activities can aggravate your plantar fascia.
- Having flat feet or high arches.
- Wearing shoes that have little support or wearing old athletic shoes.
- Having a job where you spend a lot of time on your feet e.g. working in a factory, teaching, working in a restaurant etc.
What are the symptoms?
There are a number of symptoms for this condition. The person suffering from it will likely have pain around the heel area. The pain will often be worse when you get up in the morning or after a long period of inactivity, e.g. a long drive, sitting for hours at your desk. The pain tends to ease somewhat after a few steps. There is also some pain after exercising. Generally, the pain isn’t too intense during the activity. There are varying levels of pain associated with plantar fasciitis, it can be relatively mild or even debilitating, and it usually gets worse over time.
There are a number of treatments that are effective in treating plantar fasciitis and often it is a combination of the below that is required:
- Relative rest, i.e. stop any sport that is high impact on your feet. You can do swimming or another low impact sport in the meantime. When you do return to your usual sport, start up again slowly so that you can gradually reintroduce load to the tissue.
- Anti-inflammatories and icing the foot can ease inflammation and pain associated with plantar fasciitis. You can use a frozen bottle of water to roll under your foot or you can place your foot into a bucket of icy water. Only ice for 15 minutes at a time, this can be repeated every 2 hours if desired.
- Physiotherapy is incredibly important in treating plantar fasciitis. The biggest role that Physio plays is identifying the cause of the ‘overload’. Whilst rest and anti-inflammatories can help reduce the pain, if the underlying cause is not addressed the pain/inflammation will return as soon as load is reintroduced. Some areas that Physios will assess are: flexibility of your spine, length of your hamstring and calf muscles, strength/movement patterns of your muscles and whether you may have any previous injuries/imbalances that are predisposing you to plantar fasciitis. Our treatment is then aimed at addressing what we find in your specific assessment. There is never a cookie cutter approach, well at least not at our practice. So for some of you it may be a stretching programme of your calves and hamstrings. For others it may be treating a previous lower back or hip injury which is affecting your biomechanics. It is impossible to list all the options as each person is so unique…
However, some of the techniques that we use are: massage to the feet, calves, hamstrings, hips, back; mobilisation of the many joints in the feet and ankle, the knee, the back; dry needling of any trigger points; strapping; strengthening and balancing of muscle activation; advice on shoes, relative rest options and when/how to return to sport.
- B-4 play ball. This amazing product designed by a South African is a great tool for maintaining mobility of the fascia of your foot. Out of all the home exercises that we give to clients, this is the one that actually gets done, they love it! We also use it as a preventive measure for plantar fasciitis (see our Instagram post on how to use it).
- Using heel cups. You just insert these cups into your shoes and they help absorb the shock to your heels/fascia. They also slightly raise your heels which helps to offload the stress on the fascia, both under the foot and in the calf. TOP TIP- when you first get out of bed, be it in the middle of the night or first thing in the morning, be sure to wear a shoe with a slight heel.
- Replacing worn out athletic shoes is very important. Newer shoes provide much better support and cushioning for your feet. If you are unsure about which shoes are best for you please consult with your Physio. They can direct you to a shoe store where the staff are well equipped to ensure that you purchase the correct shoe for your needs.
- Less conservative, and more expensive, treatment approaches: Night splints, a cortisone injection by a specialised doctor and surgery. None of these approaches address the underlying cause of the issue and many are associated with long term risks. So none of these options are advised until you have attempted at least 4-6 weeks’ worth of treatment with a skilled Physiotherapist.
In conclusion, physiotherapy is the best place to start when you are suffering from plantar fasciitis. The sooner you go and see a physio, the sooner the treatment can begin and the sooner we can get you back on your feet in a pain free manner. Please contact us to book an appointment.