FAQ: Plantar fasciitis
Sarah Meade 18/10/23Injury – Plantar fasciitis
Where will I feel pain? The plantar fascia is a connective tissue that runs from your toes to your heel bone. Plantar fasciitis occurs when this tissue gets injured and so the pain is then felt anywhere along the injured tissue. Most commonly the pain is felt towards the heel.
What movements will I struggle to perform if I have injured this tissue? Because the plantar fascia is a shock absorber and is tight at rest, movement and weight bearing can irritate it alone due to the plantar fascia going into a stretch stretched state under tensile load. Here are some aggravating factors:
- Movement after rest: first few steps in the morning or standing up after sitting for a while
- Walking
- Running
- Jumping
- Extended periods of standing
Will I feel pain in any other regions of my body? If you start to limp due to the foot pain, pain may arise in the low back, hips and knees. This is due to the extra load through these areas to take pressure off the foot.
Sustained limping could cause a muscle imbalance where some muscles become more worked than others, resulting in strong and weak areas in the body. This could predispose you to other injuries like a low back sprain.
How does plantar fasciitis happen? Plantar fasciitis can be caused by repetitive overuse that the body is not used to; such as beginning running or completing a much longer walk than usual).
Other factors that may contribute to plantar fasciitis occurring include; poor choice of footwear, obesity, certain foot biomechanics (high arches, flat feet) and getting older, as the plantar fascia tissue loses elasticity; becoming more easily injured.
What things should I try initially once I’ve been diagnosed with plantar fasciitis? Initially, I would suggest using ice to reduce the pain levels and resting the foot to help reduce the irritation. A good choice of footwear, seeking an osteopath or a physiotherapist for manual therapy and rehabilitation exercises to strengthen your specific biomechanics would be beneficial. Sometimes wearing a night splint to support the plantar fascia or using tape can provide relief.
What things should I try to avoid in the initial stages after being diagnosed with plantar fasciitis? Avoid barefoot walking and inappropriate footwear, wear shoes that will cushion and take load off the irritated plantar fascia. It is important to rest to promote healing initially; do not return to high-impact activities or sustained standing, running or walking when it first feels inflamed.
What type of exercises or movements do I need to learn/control/be stronger at to rehab plantar fasciitis? Exercises should be aimed at improving foot mechanics that may have predisposed this injury to initially occurring. This could include a calf stretch and stretching through the toes. Ankle mobility is also very important – so completing range of motion exercises may also help.
Strengthening could include calf raises, ankle strengthening with a theraband and scrunching a towel with your foot to improve the smaller muscles in the foot which will support the health of the plantar fascia.
What other considerations contribute to plantar fasciitis?
- Long hours of standing
- Different foot biomechanics: overpronating, over-supinating, leg length discrepancies
- Tight muscles through the feet and calves
- Some medical conditions can increase the predisposition to developing plantar fascitis such as rheumatoid arthritis and ankylosing spondylitis
What are the expected timeframes of rehabilitation? Healing times can vary depending on the severity of plantar fasciitis and the interventions taken.
The first reduction in pain can occur within 1-2 weeks with the help of rest, ice and anti-inflammatories (if needed)
You should expect pain levels to be reduced within a month if rest, manual therapy, rehabilitation and management advice have been accounted for.
For the first few months after developing the condition, it is essential to avoid flare-ups by avoiding aggravating factors, strengthening the surrounding muscles and foot mechanics and staying active to ensure the tissue returns to full health.
If managed poorly, plantar fasciitis can become chronically problematic and require further intervention which may include a cortisone injection, shockwave therapy or in some instances, surgery.