What exactly is Plantar Fasciitis?
Plantar Fasciitis is the Latin term for “inflammation of the plantar fascia”. The plantar fascia is a thick, fibrous ligament that runs under the foot from the calcaneus( heel) bone to the 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. This forme part of the reason for developing plantar fasciitis as the constant strain and pressure on the fascia causes it to develop an inflammatory condition. Plantar Fasciitis usually causes pain under the heel, however some may experience pain along the medial longitudinal arch of the foot. A heel spur may also develop due to the traction of the fascia at the bony attachment
After diagnosis of the Plantar Fasciitis, some doctors will recommend you have X-Rays taken. However, it should be noted that calcaneal spurs are not painful. They are not the primary concern!! It is interesting to note that most people suffering from Plantar Fasciitis pain do not have a heel spur! And vice-versa, there are people with a spur under one or both heels, but they have never experienced any pain!
Plantar fasciitis is in most cases experienced in the centre of the underside of the heel, or at the front or sides of the underside of the heel. The pain is more intense upon awakening and standing after periods of rest or sitting. The reason for this is that during rest our muscles and ligaments tend to shorten and tighten up. The tightening of the plantar fascia means more traction on the ligament making the tissue even more sensitive. With sudden weight-bearing the tissue is being traumatised, resulting in a stabbing pain. After a relief period with warmimg up pain generally returns with sustained periods of standing or activity. Apart from pain in the heel or symptoms may include a mild swelling under the heel. In addition, heel pain is often associated with tightness in the calf muscles. Tight calf muscles are a major contributing factor to Plantar Fasciitis
Plantar Fasciitis is simply caused by overstretching of the plantar fascia ligament under the foot. So why is the ligament being overstretched? There are different factors:
- Weight gain
- Poor Footwear
- Walking Barefoot
- Low arch/Flat feet or Over-pronation
An important contributing factor to Plantar Fasciitis is ‘excess pronation’ (or over-pronation). This is a condition whereby the feet roll over, the arches collapse and the foot elongates. This puts excessive strain on the arch and coupled with the other factors above can cause the condition to commence.
Treatment options available include conservative therapy such as local physiotherapy and trigger point massage , calf and arch stretches , cold therapy, footwear advice and orthotics to correct the biomechanical problem. More advanced therapies include Cortisone-steroid injections, Shockwave therapy, ESWT can be effective, accupuncture, Strassbourg sock and night splint and surgery for the most recalcitrant cases.