Plantar fasciitis is inflammation of the plantar fascia and is the most common cause of heel pain. The plantar fascia is the thick band of connective tissue under the foot that runs from the heel bone at the back of your foot to the toes at the front. It essentially acts like a sling to support the arch of your foot.
What causes Plantar Fasciitis?
There are a number of causes including:
Age as it is more common in middle-aged people due to ‘sagging’ of the arch of the foot, but can occur in younger people who put a lot of load through their feet.Weaknesses can occur in the muscles that support the arch of the foot, which causes the plantar fascia to take an increased load which can irritate
Poor bio-mechanics can contribute to plantar fasciitis i.e. having flat feet or high archesWeight gain or excess weight can put extra load on the plantar fascia, irritating .
the tissues; this can also occur from the weight gain during pregnancy
Repetitive loading i.e. high level sports or working on your feet
Poor support from footwear i.e. worn or ill-fitting shoes
Arthritic foot joints can irritate the plantar fascia
Diabetic people have an increased chance of suffering from plantar fasciitis
Signs and Symptoms of Plantar Fasciitis
Pain at the base of the foot near the heel with weight-bearing
More pain after getting out of bed, or after prolonged sitting
Heel pain will be worse with the first few steps and will gradually improve as you move more
Generally your physiotherapist will be able to diagnose plantar fasciitis from your history, symptoms and a clinical examination.
Calf stretches often give relief to sufferers – it is important to stretch both calf muscles, so stretch with a straight leg and also a bent leg. Hold each stretch for 30 secs and repeat twice. Try to do this at least morning and night every day.
Freeze some water in an old water bottle and roll the bottom of your foot up and down on this.
Taping can offer you some relief while you are doing your exercises to off-load the plantar fascia.
Strengthening is an important component of treatment for plantar fasciitis as it improves the ability of the foot and ankle muscles to support the arch of your foot hence off-loading the plantar fascia.
Book an appointment with one of our physiotherapists who can help you with ideas for strengthening exercises to help ease the pain caused by plantar fasciitis.
Lower back pain is a complaint that most people will experience to some degree during their lives. Sitting, standing and running posture in combination with muscular imbalances and weakness in the lumbo-pelvic or “core” region have long been widely accepted factors.
The success of mobility, coordination and strength based treatment is evident in the growing popularity of Physiotherapy exercise prescription over the past 5-10 years.
But…….. Is it possible that your unassuming feet are playing havoc with the rest of your body??
First, let me fill you in on the engineering brilliance of the human foot; 26 bones, 33 joints, 20 muscles within the foot and 13 muscles acting on the foot via the leg, all of which harmoniously work together to perform coordinated, powerful movements step after step.
The foot is designed to absorb initial impact via rolling inward (pronation) and lowering through the arch, maintain a stable base of support then act as rigid lever to propel the body-weight forward.
Unfortunately the foot and its components do not always cooperate. Due to mainly genetic factors, the foot can exhibit varying degrees of mobility resulting in either too much “rolling in” or not enough, ultimately we are left with an impaired ability of the foot to absorb, support and propel.
A rigid high arch foot structure is notoriously deficient at absorbing shock resulting in excessive jarring forces transmitted through the lower leg, pelvis and lumbar spine.
An overly flexible foot with subsequent excess pronation and arch collapse has the tendency to “slap” the ground at initial contact, immediately zapping its powers of shock absorption and setting off a chain of biomechanical events that put your precious lower back in a vulnerable position…..
Excess rear-foot pronation will increase internal rotation of the lower-leg (tibia/fibula). This excessive inward “twist” of the leg progresses all the way through the upper leg, the pelvis and stress on the vertebral column.
The human body can be extremely resilient and adaptable. Therefore, even with a less efficient foot type some individuals remain functional without a hint of discomfort. For others it may be the underlying factor to years of chronic, debilitating back pain.
There are many ways to improve the function of your marvellous feet. They are a musculo-skeletal structure just like any other part of the body ie. “the core”.
The mobility, strength and overall function can be improved with tailored exercise. In some cases additional assistance through specific footwear, with or without foot orthotics may be required to further enhance their function, improve their capacity to absorb shock and protect your back from harm.
Custom-made insoles known as foot orthoses can reduce foot pain caused by arthritis, overly prominent big toe joints and highly arched feet, a new systematic review shows.
A team of Cochrane Researchers found that custom orthoses were safe interventions for foot pain in a number of different conditions. However, more research is required to develop an in depth understanding of their effectiveness.
Approximately one in four people are affected by foot pain at any given time. It is often disabling and can impair mood, behaviour, self-care ability and overall quality of life. People suffer from foot pain for a variety of reasons, but pain is more common in the elderly and those with chronic conditions such as arthritis. In the majority of cases, patients undergo a combination of different treatments, one of which may be custom-made foot orthoses (insoles moulded to a cast of the foot).
The Cochrane Systematic Review focuses on the results of 11 trials that together involved 1,332 people. Researchers found that custom foot orthoses can relieve pain within three months in adults with rheumatoid arthritis, as well as in children with juvenile idiopathic arthritis, an early onset form of the disease. Adults with painful highly arched feet or painfully prominent big toe joints also benefited from treatment with orthoses over three and six month periods respectively.
“Custom foot orthoses can be an effective treatment for a variety of conditions, but there are still many causes of foot pain for which the benefit of this treatment is unclear. There is also a lack of data on the long term effects of treating with orthoses,” says Fiona Hawke, the lead researcher, who works at the Central Coast campus of the University of Newcastle, Australia.
Wiley-Blackwell. “Foot Pain? Custom-made Insoles Offer Relief.” ScienceDaily. ScienceDaily, 18 July 2008. <www.sciencedaily.com/releases/2008/07/080715204834.htm>.
The impact of custom semirigid foot orthotics on pain and disability for individuals with plantar fasciitis.
Division of Physical Therapy, Program in Human Movement Science, University of North Carolina at Chapel Hill, 27599-7135, USA. email@example.com
Single-group, pre-, and post intervention repeated measures design.
To determine the impact of custom semi rigid foot orthotics on pain and disability for individuals with plantar fasciitis.
Few studies have examined the efficacy of foot orthotics for plantar fasciitis, and no single study has yet examined the effects of semirigid foot orthotics on an established quality-of-life instrument.
METHODS AND MEASURES:
Eight men and 7 women (mean ages 44.7 +/- 9.0 years) who reported having plantar fasciitis symptoms for an average of 21.3 +/- 23.7 months participated in the study. Subjects were timed for a 100-m walk at a self-selected speed, then they rated the pain they experienced during the walk using a 10-cm visual analog scale. Subjects also completed the pain and disability subsections of the Foot Function Index questionnaire. All measures were acquired before the fabrication of custom semirigid foot orthotics and 12 to 17 days following onset of foot orthotic use.
Postorthotic 100-m walk times were not significantly different (t = 0.39, P = 0.70) than preorthotic values. Postorthotic pain ratings (mean = 0.7 +/- 0.7) for the 100-m walk were significantly less than (Wilcoxon t = 1, P < 0.005) preorthotic pain ratings (mean = 3.0 +/- 1.7). Postorthotic Foot Function Index pain subsection ratings (Wilcoxon t = 0, P < 0.005) were significantly less than preorthotic ratings, demonstrating a 66% reduction in pain ratings. Postorthotic Foot Function Index disability subsection ratings (Wilcoxon t = 0, P < 0.005) were significantly less than preorthotic ratings, demonstrating a 75% reduction in disability ratings.
Custom semirigid foot orthotics may significantly reduce pain experienced during walking and may reduce more global measures of pain and disability for patients with chronic plantar fasciitis.