Plantar Fascia is a connective tissue that provides a static arch support for the feet. It pads the foot as well as having elastic properties to help transmit the forces of the calf muscle, allowing you to spring. It provides shape to your foot arch, providing shock absorption and an even distribution of your weight as you put weight through your leg. Plantar fasciitis is often an overuse condition of the plantar fascia at the direct attachment to the heel bone (calcaneus). The connective tissue becomes overloaded which results in small micro tears through the tissue.
In the early stages, patients usually report discomfort and/or pain at the bottom of the heel, especially in the morning (first few steps) and after periods of inactivity. When the condition progresses, pain increases, and it is difficult to walk without a limp.
PREDISPOSING FACTORS :
Biomechanics of your foot can play a very important role :
- Low arches or flat feet- can lead to excessive strain and repetitive microtears
- High arches or rigid feet- can lead to plantar fascia shortening and therefore excessive strain
- Previous injuries- can cause compensatory adaptations changing the way you walk and cause overload of one side. g. ( If there is Pain in the left knee , our brain will subconsciously try to change how we walk to avoid the pain. That means we will start to put more weight, for longer periods of time, over the right leg to offload the left knee… the classic limp. Eventually, the right side gets overloaded and not able to recover from the repetitive microtrauma.)
- Obesity- too much body weight will obviously increase the strain on many structures but certainly your feet will get a fair share of it.
There are some systemic conditions that predispose people to develop planar fasciopathy
- Some autoimmune conditions (RA, psoriatic arthritis)
WHAT TO DO
- where possible, the predisposing factors as mentioned above.
It might sound obvious but from my experience, it almost never happens. Treating the symptoms without worrying about the causes. Obviously, the success of the treatment heavily depends on the HOW and WHY we got it in the first place. If we don’t remove/modify the predisposing factors, the condition will not improve much. Even if it does, it will tend to re-occur.
- Wear good supportive shoes (avoid barefoot walking, thongs and prolonged standing)
- Stretch your calf muscles: As the plantar fascia is a continuation of the tissues in your calf and achilles tendon, it is important to address any tension in these areas.
- Apply some ice over the painful area: 3×10 rule (10 min on, 10 min off 3 times) a couple of times per day
- Visit a health professional sooner rather than later: As an osteopath we can employ various massage techniques that can help take pressure off the tendon particularly when the condition is acute and advise you on the management of your condition.
AVOID CORTISONE INJECTIONS
For a quick fix one of the main treatments recommended is a CORTISON injection into the painful area. My advice would be to avoid this at any cost! Cortisone is an or catabolic steroid (breaks tissues down), which is the opposite to an anabolic steroid which is used to achieve excessive tissue growth, (abused in bodybuilding industry). This means that if it works, the CORTISONE would reduce the pain but not contribute to any healing. In fact, it could weaken the tissue even further leading to increased risk of further rupture in the future.
Scientific evidence shows that even one cortisone injection increases the risk of rupture significantly.
FOR A SAFER LESS INVASIVE TREATMENT FOR PLANTAR FACIITIS I RECCOMEND
Shockwave Therapy is a far better, safer, less invasive option that has been shown to successfully treat plantar fasciitis in almost 90% of people, with very little or no side effects.
Shockwave therapy is a regenerative treatment, meaning it actually helps your body to heal and regenerate injured tissue, unlike Cortisone which breaks it down.
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