Plantar fasciitis is an inflammation of the long band of connective tissue running from the heel to the ball of the foot
The plantar fascia acts like a bowstring and supports the arch and several muscles inside the foot.
When there is increased stress on the arch, microscopic tears can occur within the plantar fascia, usually at its attachment on the heel. This results in inflammation and pain with standing and walking and sometimes at rest.
Symptoms of Plantar Fascia
Plantar fascia usually causes pain and stiffness on the bottom of your heel although some people have heel spurs and suffer no symptoms at all. Occasionally, heel pain is also associated with other medical disorders such as arthritis (inflammation of the joint), bursitis (inflammation of the tissues around the joint). Those who have symptoms may experience:
- ‘First step’ pain (stone bruise sensation) after getting out of bed or sitting for a period of time
- Pain after driving
- Pain on the bottom of your heel
- Deep aching pain
- Pain can be worse when barefoot
Prevention is better than cure
- Make sure you wear appropriate supportive shoes
- Don’t over-train in sports
- Make sure you warm up, cool down and undertake an exercise regime that helps maintain flexibility
- Manage your weight, obesity is a factor in causing plantar fasciitis
- Avoid walking and running on hard surfaces if you are prone to pain
- You should follow the recognized management protocol – RICED—rest, ice, compression, elevation and diagnosis:
- Rest – keep off the injured ankle as much as possible.
- Ice – applied for 20 minutes at a time every hour as long as swelling persists.
- Compression – support the ankle and foot with a firmly (not tightly) wrapped elastic bandage.
- Elevation – keep foot above heart level to minimize bruising and swelling.
- Diagnosis – Consult a medical professional (such as a Podiatrist or doctor) especially if you are worried about the injury, or if the pain or swelling gets worse. If the pain or swelling has not gone down significantly within 48 hours, also seek treatment. An accurate diagnosis is essential for proper rehabilitation of moderate to severe injuries
When to see a Podiatrist
You should see a Podiatrist if any of the following conditions or situations apply to you:
- You have biomechanical problems such as flat feet or high arches
- You have fat-pad atrophy (decreased cushion on bottom of heel)
- You spend a lot of time standing, or you have had a recent change of occupation which has changed your standing/sitting ratio
- You have been subjected to prolonged bed rest
A Podiatrist will be able to advise on a correct treatment and management regime that may include:
- Advice on activity options
- Guidance on appropriate footwear
- The use of custom made insoles/orthotics
- The application of foot taping
- Recommendation on suitable foot exercises
- Information on appropriate oral anti-inflammatory medication and injections
- In rare cases, the area may need to be operated on
Podiatrists have an important role to play in preventing and managing foot problems. Prompt action is important. Problems which are left without assessment or treatment may result in major health risks.