What is Plantar Fasciitis?
Simply put, it is inflammation of the fascia on the bottom of the foot. There can also be changes in the fascia as a result of inflammation that cause the tissue to thicken and become gritty with less flexibility of the tissue to stretch. Plantar fasciitis typically presents as heel pain from the inflammation and increased tension and/or shortening of the fascia. It can also present as pain in the arch of the foot. The fascia spans from the heel, spreading out in a fan shape, attaching into the base of each toe. The onset of pain can be slow and progressive or come on quickly without warning and not necessarily related to specific trauma. Many people wake in the morning and complain of foot pain as they stand up and first put weight on their feet. In many cases, the pain can improve as you walk and muscles and fascia loosen up after rising in the morning but if it has progressed too far, the pain may limit the ability to tolerate walking and/or standing throughout daily activities.
What causes this?
The fascia on the bottom of the foot not only supports the arch of the foot but it has to stretch and allow movement as you bear weight on your feet to stand, walk, run, etc. If a muscle imbalance/weakness, joint or soft tissue restriction and/or altered dynamic from normal lower body mechanics has developed, this can put increased strain on the fascia of the foot as it tries to control the landing of the foot on the ground. Then the additional, repeated tension and load on the fascia creates an inflammatory reaction leading to pain and possible changes in the quality of the fascial tissue. The cause is typically multi-factorial and the treatment involves identifying the possible causes and implementing the appropriate treatment techniques to resolve the identified areas of need.
What are possible treatment options?
- Rest/Activity modification
- Night splints
- Soft tissue and joint mobilization
- Instrument assisted soft tissue mobilization-GRASTON TECHNIQUE
- Strengthening and balance training
- Muscular/Movement re-training
- Shoe wear changes
- Shoe inserts (over-the-counter/custom)
- Patient education and home programs
Skilled Physical Therapy intervention for plantar fasciitis is invaluable to identify the cause of inflammation and dysfunction and design an individualized treatment plan to resolve the problem.
Foot pain does not have to be a barrier to an active lifestyle!