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.
Figures suggest that around 80% of people experience back pain at some time in their lives. Back and neck pain can be very debilitating so how a physiotherapist manages back pain treatment is essential to secure a positive result. Back pain can be localised in and around the spine, but can also be experienced as sciatic pain. Headaches and migraines are also commonly caused by neck issues.
Exercise is important
Exercise is gaining recognition as playing a vital role in the long term recovery and in preventing many musculoskeletal injuries, including back and neck pain. Exercise compliments physiotherapy treatment management and achieve long term results when trying to prevent and rehabilitate pain and injury by correcting the underlying causes, not just seeking to stop the pain.
The underlying biomechanics that cause back and neck pain
Most back pain is caused by excessive loading placed on muscles, joints, ligaments, spinal discs, etc. due to poor core stability. Core stability is traditionally defined as; an individual’s strength and control of their lower back, pelvic and abdominal muscles in order to maintain optimal postural alignment of the lower back and pelvis.
However it is important to also include the shoulder girdle and rib cage, as the lower back and pelvis do not operate in isolation, and muscles throughout the torso must act in a coordinated manner in order to maintain optimal postural alignment and also to initiate biomechanically efficient upper and lower limb movements.
A good analogy to help understand core stability is to consider how a tent is supported. A tent is held upright by a rigid tent pole. The bones of your spine act like a tent pole, however your spine is not rigid, so it relies on the support of ligaments and deep stabilising muscles to hold adjacent vertebrae and to help maintain optimal postural alignment i.e. stabilise the spine. If the muscles that stabilise the spine, pelvis, rib cage and shoulder are weak or are poorly controlled then your spine will tend to collapse, just like a tent pole made from a piece of spaghetti. There are many muscles that attach directly onto the spine, pelvis, rib cage and shoulders. These muscles move our torso and limbs and also assist with stabilising the core, acting in a similar way that guide ropes help to keep the tent pole upright. If a tent had guide ropes that pulled more on one side than on the opposite side then the tent would lean, so too, if the muscles on one side pulled more than the other due to imbalances in strength and/ or flexibility, or these muscles compensate for weak stabiliser muscles then they will pull your body into a poor postural alignment. One very important difference to note is that a tent only requires “static stability” i.e. support to maintain a single stationary position, whereas, the human body must have “dynamic stability” to provide support and maintain optimal alignment of their core and limbs whilst moving in many different ways to participate in sport, work and daily living activities.
How a physiotherapist corrects biomechanical faults
Physiotherapists conduct a comprehensive physical assessment and then use this information to design a personalised exercise program to improve posture/ biomechanics, core stability, flexibility, functional strength, cardiovascular fitness, balance and coordination. Programs focus on achieving long term results by correcting the underlying biomechanics causes of your pain, improving the strength of muscles that support your back and neck and teaching efficient movement for your specific sport, work or daily living activities. Expert supervision by an Physiotherapist ensures that each client completes the exercises with good technique to prevent further injury, to ensure that the exercises are effective, and also to ensure that progressions are made at safe and appropriate times.
If there is one thing worth mastering to avoid injury it is the art of lifting. Setting yourself up correctly before attempting to lift something will keep you injury free. To achieve this it is best to practice the movements as an exercise to train the body so that correct posture and execution become second nature. The suitability of the pick up options below will depend on your physical condition so it is important to pick the right technique for the right situation.
The Golf pickup for lifting
Suitable for light items that can be picked up with one hand only. Saves on the effort of a squat for picking up something small like a pencil. Be sure to use your leg to counter
balance your weight. This technique is great for those who have some degree of stability and flexibility. Using a prop such as a chair, wall or table to stabilise yourself is also a good idea.
The Squat for lifting
A squat is something we often do without paying much notice to how well it is being performed. For those who lift items as part of their job, the squat is an integral part of manual handling duties.
As an exercise it is particularly good for your legs and one of the best to develop leg strength, working the kinetic link from the ankles all the way up to the hip. Stronger legs also offer greater support for the back, as performing better squat technique helps maintain correct spinal control.
So as well as strengthening our legs the squat exercise is also working our spine. As such the back should stay straight whilst the hips do the bending.
To performing a correct squat it is important to have the correct equal bend though our hip and our knees, making sure that the level of our knees is in line with but behind the level of our toes. Lowering yourself enough to create a ninety degree angle through both hip and knee, sticking the bottom down and back, plus maintaining a neutral position through the back is essential.
The Lunge for lifting
Whereas the squat offers a wide base of support and a higher power output for lifting, the lunge in contrast requires greater balance and is better for lifting smaller items.
The lunge is more like a variation of the squat. It works the same muscles but in a different way, challenging balance and control with an uneven load. Rather than both legs taking an equal load the front leg is working a lot harder to keep the body stable. The same posture principles of a squat apply, so ensure that there is an equal ninety degree bend through the hip and the knee whilst keeping your back straight. Remember when lunging it is important for the front knee not to go past the level of the front foot toes. In order to get down far enough the back heel will need to come up. When completing the lunge be sure to go down as far as is comfortable.
Remember that the co-ordination involved in performing these techniques for lifting and the use of momentum will lessen the need for isolated muscular strength and aid injury prevention. Also by switching on your core stabilising muscles on before doing any of these movements you will have greater control over the movement.
By doing a mixture of squats, lunges and golf lifts you will benefit from working a variety of muscles in different ways. Also if you happen to acquire an injury then having options as to how you pick something up will better enable you to rely on other muscles whilst the injured area recovers.
Incorporating these exercises into a routine and performing them correctly, will ensure that when you do need to use them in a practical manner throughout the day, that you are moving correctly.