Plantar fasciitis

Definition

The plantar fascia is a thick band of tissue that forms the base of the foot (the plantar arch). It starts at the heel and attaches to each toe. The fascia becomes tense when standing up or standing on tiptoe. Plantar fasciitis is the inflammation or fibrosis of this fascia that occurs as a result of trauma or repeated stress on the fascia.

Causes

The causes of plantar fasciitis can vary:

  • Decreased mobility of the ankle
  • Flat feet or hyper pronation of the foot
  • Extended walk or run
  • Inadequate shoes
  • Foot or ankle trauma
  • Alteration of the walking pattern

Symptoms

Plantar fasciitis usually produces pain in the heel. The pain is often worse in the morning or after a period of rest and fades during the day. The hollow of the foot can also be sensitive to touch, especially if the toes are placed upwards. The pain increases with walking as the fascia is put under tension. It is sometimes possible to observe a slight limp or difficulty walking in irritable cases.

Preventive advices

Plantar fasciitis can be prevented in a variety of ways. The purchase of well-fitting shoes that support the plantar arch greatly decreases the chances of developing fasciitis. For athletes, it is recommended to choose a shoe specific to the sport and to regularly stretch the calf and the plantar fascia after physical activity (especially for runners). This helps to maintain good flexibility and to reduce tension in the fascia.

Healing and physiotherapy treatment

Plantar fasciitis can last for a few months, but normally resolves in less than 6 months using a conservative approach of stretching and strengthening. To optimize healing, you may be advised to reduce the intensity of your activities. Physiotherapy treatments will start with anti-inflammatory techniques such as ultrasound, iontophoresis and ice application. Stretches of the calf and plantar fascia can then be undertaken. The last treatments will aim to strengthen the muscles of the foot and leg. Your physiotherapist will use different techniques such as manual therapy to increase joint mobility and tapping to loosen the musculature and support the arch. In some cases, you will be referred to consult an orthotist to assess the shape of the arch and verify if plantar orthotics are needed.

Do not hesitate to consult your physiotherapist if you feel pain under your foot. He or she will give you advices on which exercises to start if you have this condition and will help you recover quickly to return to your activities.