What is Plantar Fasciitis?
The plantar fascia is a broad band of connective tissue, which not only supports the arch of the foot, but also plays an important role in normal foot biomechanics.
The fascia is designed to support the longitudinal arch of the foot.
It attaches at the base of the heel bone and runs the length of the foot to insert into the bases of each toe.
The plantar fascia is placed under tension during preparation for toe off during gait; the fascia is designed to provide static support by tightening to stiffen the foot to allow affective propulsion.
What are the causes?
Plantar fasciitis is a common overuse injury, particularly seen in runners with research indicating can account for 8-10% off all running injuries. This has been thought to be due to repetitive microtrauma at the point of insertion.
Some of the most common risk factors include:
Pes Planus (Flat feet): this causes excessive mobility in the foot, placing additional strain on the fascia due to increased stretching forces and reduced arch support. (Over pronation)
Pes Cavus (High arch): generally causing increased stiffness within the arch, and subsequently reducing the shock absorption properties of the foot. (Excessive supination)
Training errors: increases in mileage, changing terrain and inadequate recovery can place the individual at increased risk of developing plantar fasciitis, new runners who take on too much too soon are particularly at risk.
Muscle imbalances in strength and flexibility: research has suggested that tightness in the posterior muscles (hamstrings, gastrocnemius and soleus) may contribute to developing this condition. Poor strength and conditioning of the hip flexors, abductors and tibialis anterior muscles have been found to possibly contribute to the development of plantar fasciitis.
Inappropriate footwear: Appropriate running shoes should be the most important purchase by any runner, altered foot mechanics such as over pronation can cause excess stress on the plantar fascia. Wearing adequate footwear will enable the foot to function more effectively, which will subsequently reduce the impact on the more proximal structures.
What are the symptoms?
Pain associated with plantar fasciitis is usually of gradual onset; it is typically painful at the beginning of activity, which often eases, only to return once activity ceases. If left untreated the pain increases to the point where weight bearing is painful and made worse with activity.
Pain is usually described as being worse in the morning, this is due to the foot being held in a plantarflexed position which when standing this movement is rapidly reversed.
Pain is typically felt on the medial (inside) aspect of the heel at the insertion to the calcaneus.
How to manage the pain?
As with any overuse injury, early management is essential, the longer it goes untreated the more difficult treatment would be.
In the initial stages it’s best to avoid any aggravating activities, any activity, which doesn’t cause pain, can be performed, for example swimming, cycling and cross trainer.
Anti inflammatory medication and ice may be beneficial in the early stages
Initiation of a strength and flexibility program, with particular emphasis placed on stretching the posterior muscles and strengthening of the hip flexors and abductors.
Wearing the correct footwear, visiting a specialist footwear store such as Run 4 It will ensure you are measured correctly for the most appropriate shoe for your running style.
Self massage to the plantar fascia with a massage ball.
Sports massage and mobilisations have been found to be an effective method of reducing the pain associated with plantar fasciitis, increasing the mobility at the joint and improving the muscles flexibility, will enable the individual to perform the necessary strengthening exercises which are essential to ensure a speedy return to running.