GET THE SPRING BACK IN YOUR STEP

An image of a patient suffering from plantar fasciitis - Moreno Osteopathy, you're in good hands
PLANTAR FASCIITIS – HOW TO GET THE SPRING BACK IN YOUR STEP

Are you experiencing persistent pain and stiffness in the bottom of your heel or foot? Affecting one in ten people at some point in their lives – the cause could be plantar fasciitis.

WHAT IS PLANTAR FASCIITIS AND WHAT CAUSES IT?

Plantar fasciitis is the inflammation and irritation of a fibrous band of connective tissue that runs underneath the sole of the foot. This band normally acts to support the arch of the foot and absorb pressure placed on the foot from walking and running, and from the top down by dispersing the weight of the body.

The underlying cause of plantar fasciitis tends to be multifactorial however it is often considered to be an overuse injury. Overloading and repetitive stress can cause micro-tears to the plantar fascia leading to an inflammatory reaction that quickly causes pain.

You are more likely to injure your plantar fascia in certain situations, for example:

  • If you have recently started exercising on a different surface;
  • If you are on your feet for a lot of the time or if you do lots of walking, running, standing etc. when you are not used to it or have previously had a sedentary lifestyle;
  • If you have been wearing shoes with poor cushioning or poor arch support;
  • If you are overweight;
  • If there is sudden stretching or overuse of the sole;
  • If you have a tight Achilles’ tendon.

Commonly seen in runners, plantar fascia is also known as ‘jogger’s heel’ due to repetitive stress on the foot and often chronic tightness in the hamstrings, calves and Achilles tendons.

WHAT ARE THE SYMPTOMS?
  • Pain on the underside of the heel or in the arch of the foot.
  • Sharp pain in the morning or after rising from prolonged sitting.
  • Difficulty walking distances, running or standing for long periods of time.
WHAT SHOULD I DO TO EASE THE PAIN?

Although plantar fascia can be self-limiting, it can take up to year or so for symptoms to ease! You don’t have to suffer however as there are many simple and effective ways to alleviate the symptoms of plantar fasciitis. A conservative approach is always recommended initially (Luffy et al., 2018).

We advise that you try the following:

RICE
  • Rest: Resting is important with plantar fasciitis, avoiding vigorous activities for a while such as running, excess walking or standing for prolonged periods of time.
  • Ice: Icing will help reduce inflammation of the plantar fascia ligament. Ice twice a day for around 10-15 minutes, and immediately after exercise.
  • Compression: Tape or wrap heel if you notice swelling.
  • Elevation: Rest with your feet raised above heart level to improve circulation.
STRETCHING

Gentle walking and exercises including stretches of the muscles at the back of the leg and your Achilles tendon are crucial along with stretching the plantar fascia by pulling your toes back.

  • Achilles tendon and plantar fascia stretch – Loop a towel, a piece of elastic or a Tubigrip around the ball of your foot and, keeping your knee straight, pull your toes towards your nose holding for 30 seconds. Repeat 3 times for each foot.
  • Wall push-ups or stretches for Achilles tendon – Face the wall, put both hands on the wall at shoulder height, and stagger the feet (one foot in front of the other). The front foot should be approximately 30cm (12 inches) from the wall. With the front knee bent and the back knee straight, lean into the stretch (towards the wall) until a tightening is felt in the back of the leg. Hold this position for 30 seconds and then ease off. Repeat 10 times.
  • Stairs stretches for Achilles tendon and plantar fascia – Holding the stair rail for support, with the legs slightly apart, position the feet so that both heels are off the end of the step. Lower the heels, keeping the knees straight, until a tightening if felt in the calf. Hold this position for 20-60 seconds and then raise the heels back to neutral. Repeat 6 times at least twice a day.
MASSAGE

Massaging the sole of your foot over a rubber ball or similar.

ANALGESIA

Pain relieving medications such as Paracetamol or Non-Steroidal Anti-Inflammatory Drugs such as Ibuprofen are recommended on a ‘as required basis’ to alleviate pain (NICE, 2015).

THE BEST WAY FORWARD

Plantar pain is not always plantar fasciitis. Similar pain in the foot can also be caused by calcaneal stress fractures, nerve entrapment or neuroma, heel pad syndrome and plantar warts. It is really important that your heel pain is properly assessed so that it can be appropriately managed.

Ongoing pain can lead to further problems such as lower back pain and Achilles tendonitis (Mcclinton et al and Nakale at al). Seeking advice and treatment as early as possible will help to prevent chronic pain and other issues. Osteopaths are trained to identify and treat the cause of you pain. To find out more information on how we can help you please contact us.

REFERENCES

Luffy, L., Grosel, J., Thomas, R., So, E. Plantar fasciitis: A review of treatments (2018) American Academy of Physician Assistants.

McClinton, S., Weber, CF., Heiderscheit, B. Low back pain and disability with plantar heel pain (2017) Science Direct (34) 18-22

Nakale, N., Stydom, A., Saragas N., Ferraro, P. Association between plantar fasciitis and isolated gastrocnemius tightness.

NICE Guidelines. Last revised June 2015 Scenario: Management of plantar fasciitis.