PLANTAR FASCIITIS

Plantar fasciitis is a common condition characterised by inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of the foot connecting the heel bone to the toes. This inflammation typically causes stabbing pain near the heel especially with the first steps in the morning or after prolonged periods of rest. Plantar fasciitis is often caused by repetitive strain or overuse of the foot, improper footwear, tight calf muscles or biomechanical issues like flat feet or high arches.

Understanding Plantar Fasciitis:

1. Causes: The exact cause of plantar fasciitis is multifactorial, but common factors include:

• Overuse or repetitive activities that strain the plantar fascia (e.g. running, walking long distances).

• Foot mechanics such as flat feet, high arches or abnormal gait patterns.

• Tight calf muscles or Achilles tendon.

• Obesity, which increases stress on the plantar fascia.

• Poor footwear that lacks support or cushioning.

1. Symptoms:

• Pain and tenderness near the heel, usually worse in the morning or after prolonged periods of rest.

• Pain that improves with activity but may worsen again after prolonged standing or walking.

• Stiffness and limited mobility in the foot, especially in the morning or after sitting for a while.

1. Diagnosis: Plantar fasciitis is typically diagnosed based on clinical symptoms and physical examination. Imaging studies like X-rays or ultrasound may be used to rule out other causes of heel pain.

How Physiotherapy Can Help with Plantar Fasciitis:

Physiotherapy plays a crucial role in the management of plantar fasciitis by addressing pain, improving flexibility, strengthening the foot and ankle muscles and correcting biomechanical issues. Here are ways physiotherapy can help:

1. Stretching Exercises: Physiotherapists prescribe specific stretching exercises to lengthen the calf muscles, Achilles tendon and plantar fascia. These exercises help reduce tension and improve flexibility in the foot and ankle.

2. Strengthening Exercises: Targeted exercises to strengthen the intrinsic foot muscles and lower leg muscles (e.g. calf raises, toe curls) help support the arch of the foot and reduce strain on the plantar fascia.

3. Manual Therapy: Techniques such as soft tissue mobilisation, massage and myofascial release can help reduce muscle tightness, improve tissue mobility, and alleviate pain in the affected area. 

4. Orthotic Devices: Physiotherapists may recommend or prescribe orthotic devices such as shoe inserts or arch supports to provide additional support and cushioning to the foot, correcting biomechanical issues and reducing strain on the plantar fascia.

5. Activity Modification: Guidance on modifying activities or sports that aggravate symptoms of plantar fasciitis. Physiotherapists can provide alternative exercises or techniques to minimise stress on the foot.

6. Gait Analysis and Correction: Assessment of walking and running mechanics to identify abnormal gait patterns or foot posture issues contributing to plantar fasciitis. Physiotherapists can then implement corrective strategies to improve gait mechanics and reduce strain on the plantar fascia.

7. Modalities: Therapeutic modalities such as ultrasound, laser therapy or electrical stimulation may be used to reduce pain, inflammation and promote tissue healing in the plantar fascia.

8. Taping: Taping can be used to support the plantar fascia and reduce the tension in the affected area.

Benefits of Physiotherapy for Plantar Fasciitis:

• Non-Surgical Approach: Physiotherapy offers conservative treatment options to manage symptoms and promote healing without the need for surgery.

• Customised Treatment Plans: Tailored interventions based on individual needs, symptoms and contributing factors.

• Long-Term Management: Education on self-management strategies, including stretching, strengthening exercises and preventive measures to reduce the risk of recurrence.

In summary, physiotherapy is essential in the management of plantar fasciitis, providing effective, personalised treatments aimed at reducing pain, improving flexibility and strength, correcting biomechanical issues and promoting long-term foot health. Early intervention with physiotherapy can lead to significant symptom relief and functional improvement, allowing individuals to resume normal activities with reduced pain and improved mobility in the affected foot.