Heel pain is a common complaint that patients come in to our clinic with, particularly during the summer months. Often this pain is caused by a condition that you may have heard of, and may even dread – Plantar Fasciitis (or fasciopathy). Read on to find out more about plantar fasciitis and how your physiotherapist can help you to manage this painful condition.
What is Plantar Fasciitis?
The plantar fascia is a thick band of connective tissue that runs from the heel bone to the toe bones, underneath your foot. It’s job is to support the arch of the foot and to work as a shock absorber during walking, running and jumping. When this fascia becomes irritated or painful it is known as plantar fasciitis.
Risk factors for developing plantar fasciitis include:
· Standing for long periods of time
· Excessive foot pronation (flat feet)
· Stiff ankles
· Being overweight
Signs and symptoms
Generally with plantar fasciitis, you suffer stabbing pain in the middle of your heel. This pain tends to be worst first thing in the morning but warms up as the day goes by. However, the pain is often worse again when you stand up if you have spent a long time sitting.
Step 1 – Rest
The first treatment for plantar fasciitis is rest. This means having a break from exercises and activities that cause pain. Your physiotherapist can also apply a taping technique to your foot called 'Low Dye Taping' to support the arch and give the fascia a chance to rest. This taping technique is very helpful in decreasing pain but still allowing you to get on with day to day activities. If necessary, your physiotherapist may refer you to a podiatrist if they think orthotics might be helpful.
Step 2 – Stretches and Release Work
Stretching and muscle release are also crucial to treating plantar fasciitis. Stretches to the calf and hamstring muscles are useful, as well as stretching and releasing the fascia. You can do this by rolling a golf ball or a spikey ball under the arch of your foot for a few minutes, several times a day.
Step 3 – Pain Management
Other things that can help to decrease the pain with plantar fasciitis are using an icepack to the heel throughout the day and taking anti-inflammatory drugs such as Nurofen or Voltaren (check with your pharmacist or GP first).
As the pain in your heel begins to settle down, your physiotherapist will prescribe exercises to strengthen the arch, ankle and calf muscles. This is important to help correct any muscle weaknesses that may have contributed to developing plantar fasciitis in the first place. It is also important to make sure your shoes are supportive enough – remember that running shoes only have a 6-12 month lifespan!
When you do begin to exercise again, it is very important that you start slowly and work your way back up to full capacity. If you feel pain during an exercise or worse the next morning, then it may mean that you overdid it and need to dial back the intensity next time. If in doubt, talk to your physiotherapist and develop a pacing programme.
Feel free to call the clinic on 9438 3444 if you have any questions about heel pain or pop in to have a chat with one of our friendly physiotherapists.
By Sarah King - Physiotherapist and Clinical Pilates Instructor
Assad, S., Ahmad, A., Kiani, I., Ghani, U., Wadhera, V., & Tom, T. N. (2016). Novel and Conservative Approaches Towards Effective Management of Plantar Fasciitis. Cureus, 8(12), e913. http://doi.org/10.7759/cureus.913
J Orthop Sports Phys Ther. 2014; 44(11): A1-A23. doi:10.2519/jospt.2014.0303