What is Plantar Fasciitis?
Your plantar fascia is a strong band of connective tissue on the sole of your foot connecting from your heel to your mid-foot. This supports the arch and helps to absorb forces. Plantar fasciitis occurs when this connective tissue becomes inflamed which results with pain in the sole of your foot.
Pain is the main symptom of this injury particularly when you are weight bearing and it’s tender to touch. Your pain will be worse when you start walking after sleeping or resting. Moreover raising your toes off the floor will be difficult. You will feel better during exercise but it does return after resting.
What is the cause of Plantar Fasciitis?
Plantar Fasciitis can be caused by a sudden increase in running intensity and distance. Also starting exercising on hard surfaces that you are not used to. Moreover really tight calfs and hamstring muscles will cause additional tension into the plantar fascia. Similarly reduced ankle movement will cause an increase in forces going through the foot and ankle whilst running. Predisposing factors are being overweight will cause additional mechanical loading and individuals between 40 and 60 years old. However it also affects a younger population of habitual runners (Buchbinder 2004).
How is it diagnosed?
Your GP or a manual therapist (Osteopath, Physiotherapist or Chiropractor) can diagnose and treat the condition.
What are the treatment options?
Is a non surgical, hands on treatment which firstly questions why are you experiencing pains. At Wellthy clinic we examine your feet, ankles, knees, hips and posture as a whole to identify why you are experiencing symptoms. Your hips may not be moving as well as they can do which causes additional loading through your plantar fascia when you run. Very tight calf and hamstrings muscles causes additional stress into your sole of your feet. Reduced ankle movement can again increase pressure into your plantar fascia. Your gluteal and core muscular strength could be improved which helps balance your pelvis when you run.
An Osteopath will provide hands on therapy aimed to articulate and manipulate your joints (if appropriate) to increase joint function. An Osteopath will provide a holistic treatment (not just treating your feet). Provide active stretching for your tight muscles and reduce pressure into the soles of your feet. We give specific stretching and strengthening exercises aimed to speed up your recovery process. In addition, advise on basic hydration and nutrition to help accelerate the healing process.
We offer FREE 15 minute consulations with our Osteopaths.
Meaningful movement and Pilates exercises are great for plantar fasciitis. The combination of stretching and strengthening exercises can help take pressure away from your feet. Safe stretching of your calf and hamstring muscles will help with your ankle function. Exercise helps increase blood flow to optimise inflammatory processes. Strengthens muscles and self empowers you to feel a little bit better. Pilates exercises will be graded depending on the severity of your symptoms, regularly reviewed and changed to ensure progression.
As mentioned before plantar fasciitis is where your plantar fascia has become inflamed (itis). There are foods which high in inflammatory content and foods which are anti inflammatory. You are in control of the foods you eat and therefore you can reduce foods high in inflammatory content and eat more anti inflammatory foods. This will affect the amount of inflammation within the body and optimise your body’s ability to recover. Not only this a Nutritionist would address your current diet and develop a bespoke plan for you to help you reduce your pain levels. Everybody is different and so are people’s nutritional needs so having a tailored plan for you will make a difference.
Naturopathic Nutrition takes a holistic view of health and considers organic and whole foods as medicine. It is an evidence based approach to health which treats the body as a whole, while taking into account our lifestyle factors. We suggest Chemical-free foods and other dietary changes to help reduce your symptoms. A naturopathic nutritionist will also address your current lifestyle and question suggest making small changes which can make a big difference. We offer FREE 15 minute consulations with our Nutritionist.
Typically a GP will prescribe paracetamol and/or non steroidal anti‐inflammatory drugs. A GP will give advice on wearing comfortable footwear and may refer to podiatrist or physiotherapist.
A podiatrist will prescribe insoles to reduce forces into the plantar fascia for short term relief. They will question whether the foot excessively rolls in when walking or running which can be reduced with insoles. They will advise on the right shoes to wear and to reduce your amount of training. A podiatrist will give stretches for the plantar fascia and calf muscles. Similarly core stability to stabilise your pelvis. Long standing pain can be treated with shock wave therapy which stimulates tissue healing.
Will give appropriate exercises. A physio may also recommend shock wave therapy, laser and steroid injections. A recent cochrane review (2017) reported that local steroid injections may slightly reduce heel pain up to one month but not subsequently.
Sports massage is beneficial for plantar fasciitis. A sports massage will involve a firm pressure to encourage further blood flow to your tight muscles to optimise healing. It is a great way to support your training, reduce muscle tension and relax. Within a sports massage we can also provide some active and passive stretching to help. It is common to feel sore the day after a treatment but then you should your muscles should feel a little looser. Plantar fasciitis can take a while to recover so combining approaches (Osteopathy, Nutrition, Pilates and Sports Massage) will give your body the best chance of recovery.
Buchbinder R. Plantar fasciitis. The New England Journal of Medicine 2004;350(21):2159‐66.
Cochrane (2017) Injected corticosteroids for treating plantar heel pain in adults https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009348.pub2/full?highlightAbstract=fasciitis%7Cplantar%7Cfasciiti
NHS (2020) Plantar Fasciitis https://www.nhs.uk/conditions/plantar-fasciitis/