The plantar fascia is a thick connective tissue connecting the ball of your foot to the heel which supports the long arch of your foot. Plantar fasciitis develops as a result of repetitive strain on the plantar fascia, usually due to poor biomechanics, large increases in weight bearing activity, poor footwear or tight calves. It is most commonly found in people over 30 years of age and up to 10% of the adult population will experience it at some stage. Persistent inflammation leads to the development of scar tissue, shortening in the fascia and changes in the blood vessels in the area.
Symptoms of Plantar Fasciitis
- Pain on the inside aspect of your heel. It may be an aching or burning sensation, or feel like you have been bruised by a stone.
- The onset is usually gradual over a number of months.
- Pain is usually worst in the morning, affecting the first few steps you take after waking.
- You may also experience a similar pain when walking after sitting for an extended period of time.
- Pain decreases with activity, but returns 12 – 36hrs following exercise or periods when you are on your feet for a long time.
Management
Taping or provision of orthotics to support the arch and offload the irritated tissue is usually helpful in plantar fasciitis injuries.
Stretching the calf and plantar fascia, often rolling on a golf ball to release the tissue on the underside of the foot.
Physiotherapy usually involves stretching and tissue release to the bottom of the foot as well as provision of strengthening exercises to improve biomechanics and taping the foot to offload irritated tissue.
In stubborn cases, the use of a night splint to reduce tissue shortening while sleeping may be required.
