Plantar fascitis injuries
Plantar fascitis is inflammation of the fascia (thick band of tissue) at the bottom of the foot where it attaches to the heel bone. This is common in athletes who do a lot of running and jumping. There is gnawing pain or discomfort in the heel that radiates along the sole of the foot. It is also associated with flat feet, over pronation, obesity and jobs that require a lot of walking over hard surfaces. Shoes with little or no arch support and inactivity may also contribute to this condition. Plantar fascitis often results in a heel spur, in which the pain is caused by the underlying condition and not the spur itself. Plantar fascitis responds well to anti-inflammatory medication, however the condition may take as much as four years to resolve.
Symptoms of plantar fascitis are:
- Pain under the heel and usually on the inside, but pain may occur on the outer border as well.
- Pain is usually worse first thing in the morning when you stand. After a few minutes it eases, but can get worse again during the day especially if walking a lot.
It is important to rest the foot, as continuing to bear weight on it can aggravate the injury and cause inflammation. Crutches may be helpful to allow you to get around. Icing helps to reduce pain and inflammation. We will assess the biomechanics of the foot and make recommendations. If there is over pronation, we may recommend that you be fitted with orthotics to correct this problem, as over pronation can flatten the foot and stretch the fascia. Orthotics should be worn at all times, not just when training.
Taping is another effective physiotherapy intervention. It helps by giving support, especially if you cannot stay off your feet. Gentle stretching will be started on the first day of treatment if pain will allow. Stretching is done not only for the fascia, but also for all the muscles of the lower leg, especially the calf muscle, as tight calf muscles can lead to pronation of the foot with its attendant problems mentioned above.
Night splints can be used to improve calf muscle flexibility and reduce early morning pain. Night splints keep the foot in a dorsi-flexed (bent upward) position during sleep. We will train you in stretching the Achilles tendon before getting out of bed in order to decrease morning pain. And of course it is important to stay off the feet as much as possible.