Plantar Fascia Pain- be gone!
Updated: Sep 6
Feet are out foundation. Our feet support out body in standing and walking. Our feet are the first to absorb impact from landings. Out feet are important. And.. our feet often cause us pain. The foot is a flexible structure of bones, joints, muscles and ligamenets. The foot is made up of 26 bones and 33 joints. There are 19 muscles and 107 ligaments. The foot is highly complex and manages to work in a co-ordinated way. it is strong but also mobile to achieve motion and balance.
Heel pain and more specifically plantar heel pain can really be a pain in the butt. When you have it, it is hard to avoid - it is literally there with every step. The most common cause of plantar heel pain is plantar fasciitis.
Other causes to look out for are: calcaneal stress fracture, fat pad syndrome, nerve entrapment, neuromas, arthritis or referral from further up the chain.
Your plantar fascia is a thick, fibrous band of tissue that runs from the base of the heel bone - the calcaneum - along the base of the foot to the toes. The pain usually appears out of nowhere, however it most commonly occurs due to chronic overload. There comes a time when it just becomes to much and pain ensues. There is a common pattern of pain - it is worse with the first steps in the morning and generally gets a bit better after a short period of walking. The pain often comes back after prolonged activities that include weight-bearing.
Plantar fasciitis is an injury that can occur in both active and sedentary people. The overload of the tissue is all relative to the previous function and loading of the tissue. Treatment for plantar fasciitis is generally non-invasive and efficacious. Physiotherapy and podiatry are the most important professionals for management and improving pain and function.
The management of plantar fasciitis involves looking at your biomechanics and what might intrinsicialy be contributing to the presentation. It is also so very important to look at extrinsic factors - none more important in this case than shoes.
Shoes can be the culprit but ultimately shoes will be your saviour. Inappropriate or unsupportive footwear can certainly contribute to the presence of plantar fasciitis. The plantar fascia endures incredible loads and weight-bearing for prolonged periods in inappropriate shoes can overload this area. But shoes, glorious shoes are the saviour. The pain in the plantar fascia is commonly the worst on those first steps out of bed so keep a pair of comfortable, supportive shoes next to your bed to put on straight away. See a podiatrist for shoe and footwear advice. It can make the world of difference. Physiotherapy and podiatry work well in conjunction for foot and lower limb problems.
Plantar fasciitis is similar to a tendinopathy - it has similar pathology and also responds similarly to loading. Tendons love load - progressive load. Strengthening both the big muscles supporting the area such as the calf and also the little muscles of the foot, has the best outcomes for managing this painful problem.
Calf strength using a towel underneath the toes has been shown to help reduce pain quicker than stretching the plantar fascia alone. The towel maximises the function of the planar fascia. How many, how often, and how to perform the exercise all depend on the individual.
The little muscles of the feet are called the intrinsic muscles. They help move the foot and also help support the arches of the feet. It has been found that these muscles are smaller in those experiencing pain from the plantar fascia. Learning how to use them is an important part of the rehabilitation process - they are also important for rehabilitating many other musculoskeletal injuries. Exercises such a doming the arch, spreading the toes and lifting the big toe independently are some of the options for strengthening these little muscles.
Local area management is important to get started and get the pain under control and return to function. It is then important to look at the way you move and the other elements that may have contributed to this problem. Addressing the causes helps to prevent further episodes.
Our Physiotherapists at The Movement Workshop can help to kick-start your recovery from plantar fascia pain. We work alongside Melbourne Family & Sports Podiatrist, Kim Scott, to provide our patients with the best care for their feet and long-lasting results.