Plantar fasciitis is the most common cause of heel pain. The plantar fascia is the thick fibrous band of tissue that connects your heel bone to your toes. It forms the arch of the foot and functions as our natural shock-absorbing mechanism. Unlike muscle tissue, the plantar fascia is not very elastic and therefore is very limited in its capacity to stretch or elongate. So when too much traction is placed on the plantar fascia micro-tearing will occur, resulting in inflammation and pain.
Is it a heel spur?
A heel spur is a bony growth at the front/underside of the heel bone. The reason for the development of a spur is that the body ‘responds’ to the constant traction and pulling from the plantar fascia ligament away from the heel bone. The ligament itself cannot become any longer, so instead the bone will ‘assist’ the ligament and grow. Rarely a heel spur will actually cause pain.
Symptoms
Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. You may have less stiffness and pain after you take a few steps. But your foot may hurt more as the day goes on. You may change the way you walk to relieve the pain. This eventually may lead to more discomfort and pain and other problems with your foot, leg, hip, or back. You eventually may have pain with any weight-bearing activity.
Causes
Overuse from Biomechanical issues such as foot position and flexibility, tightness in calves or plantarfascia, repetitive activities that involve prolonged walking, running or standing, training errors, poor footwear, sudden weight gain, age, traumatic injury from a fall or jump.
Treatment
Rest/Modify training – minimise excessive weight bearing and repetitive exercises
Ice/heat
Anti-inflammatory oral and topical medications – Voltarin, deep heat, fisiocream etc.
Massage – along the arch and heel. Use golf ball, tennis ball, rolling pin or frozen water in bottle
Mobilisation – ankle
Stretching – plantarfascia and calf
Strengthening – calf raises, arch raises and alternating toe clawing exercises
Acupuncture, dry needling, cortisone injection or prolotherapy
TENS, ultrasound, laser or shockwave treatment
Strapping or brace
Appropriate footwear – firm rear foot and midfoot.
Orthotics – pre-fabricated or custom
Surgery- rarely warranted and used as last resort
