PLANTAR FASCITIS

 The Injury

• The plantar fascia is a fibrous sheath that runs most of the length of the sole of the foot.
• It attaches between the heel bone and the bones at the base of the toes, covering the small muscles in the sole of the foot.
• During walking and running, as you 'toe-off', the plantar fascia becomes taut and helps the foot act as a lever to push off with force.
• Plantar Fascitis refers to inflammation of the plantar fascia, usually at the point where it attaches to the bone. 
• This condition usually occurs in older individuals, where the movement in the joints of the foot has become restricted.
• It may also occur in individuals who do a lot of standing, walking or sporting activities, usually as a result of overuse.

 Signs and Symptoms

• Pain is common over the inside of the heel and usually radiates down the inside of the sole of the foot.
• The pain usually occurs with activity and is also typically present in the morning when taking the first steps of the day.
• Plantar Fascitis can be diagnosed by a doctor or physiotherapist, if pain is present on touching the affected area, and/or on stretching the plantar fascia (by pulling the toes up).
• Occasionally it may be necessary to get an x-ray to rule out other conditions such as a bony spur on the heel bone or a fracture of the heel bone

 Treatment & Prevention

• Plantar Fascitis is inflammatory in nature and the key to successful treatment is to determine what is causing the inflammation and address this problem.
• In most sporting individuals the cause is overuse and the remedy is simply to allow adequate rest, which will allow the affected tissues time to heal.
• In other cases there may be a problem with the biomechanics of the foot, contributing to the problem. If this is the case (which is likely if rest alone does not rectify the problem), it is wise to seek the advice of a podiatrist.
• The podiatrist will assess the mechanics of the joints of the foot (there are over 30 of them) to see if they are functioning correctly.
• It may be that these joints are stiff and can be treated by mobilizations, where the physiotherapist gently moves the joints manually to remove the stiffness and restore the normal range of movement.
• Conversely, there may be too much movement in the joints of the foot and the podiatrist may insert an orthotic (shoe insert) to correct the problem.
• While the plantar fascia is still painful it may be treated with ice packs (never apply ice directly to the skin) and anti-inflammatory drugs prescribed by a doctor. Once the pain has subsided it is thought that stretching the plantar fascia (by pulling the toes towards the shin) is effective in encouraging the tissue to regain its strength.