Plantar Fasciitis: An Overview
In Introduction to plantar fasciitis
Plantar fasciitis is the most common cause of heel pain in patients. It is a painful condition that can affect people of all ages and activity levels. Thankfully, your sports podiatrist is an expert in diagnosing plantar fasciitis, and there are a number of effective treatments available.
What is plantar fasciitis?
Plantar fasciitis is a painful condition of the heel of the foot. When plantar fasciitis occurs, the plantar fascia ligament becomes irritated and inflamed. It may also become significantly thickened. The plantar fascia ligament is a strong, dense structure that is located at the base of the foot. It connects the heel bone to the toe bones at the ball of the foot. The plantar fascia’s function is to help with weight bearing and force distribution through the foot when a person walks. It also assists the arch of the foot to stay supported in an upright position.
What are the symptoms of plantar fasciitis?
Plantar fasciitis causes some characteristic signs and symptoms in its patients. Some of these include:
- Sharp, stabbing or burning pain in the base of the heel
- Pain that is usually at its worst when getting up out of bed in the morning, but typically subsides after a few minutes of walking
- Pain after prolonged periods of sitting or standing
- Pain immediately following a period of intense exercise.
What risk factors increase the chances of developing plantar fasciitis?
Plantar fasciitis can occur in people of all ages and activity levels, however there are risk factors that can increase a person’s chances of developing the condition. Some of these risk factors include:
- Age: people aged between 40 and 70 are at greatest risk
- Sex: females are at greater risk than men
- Pregnancy: females often experience bouts of plantar fasciitis during pregnancy, especially with sudden weight gain and ligament laxity
- Overweight and obesity increase a person’s risk of developing plantar fasciitis
- People who run often or over long distances are at increased risk
- Occupation: people whose jobs require them to be on their feet for long periods are at increased risk
- structural problems of the lower leg and foot: people who have high arches, flat feet, or tight Achilles tendon and calf muscles are at increased risk
- Footwear: wearing very flat or unsupportive footwear such as ballet flats or flip flops increases a person’s risk of developing plantar fasciitis.
How is plantar fasciitis diagnosed?
Your sports podiatrist is an expert in diagnosing plantar fasciitis. The diagnosis of plantar fasciitis is often made based upon the patient’s presenting symptoms and clinical signs. The sports podiatrist considers the patient’s exercise and medical history and lifestyle. They conduct a thorough physical examination, including palpating the foot to see if the pain can be pin-pointed or reproduced. A biomechanical analysis is carried out in most cases, in order to assess the patient’s gait (style of walking or running). This allows for the sports podiatrist to determine if there are any structural abnormalities, malalignments or imbalances in the lower limb and foot that could be contributing to the patient’s heel pain and plantar fasciitis. In some situations, diagnostic imaging, such as an ultrasound or xray may be required in order to rule out other differential diagnoses such as bursitis.
What are the treatment options for plantar fasciitis?
Your sports podiatrist may recommend a number of different treatments for plantar fasciitis. The methods that they choose to incorporate in to your treatment plan will be largely based upon the results of the biomechanical analysis, and any lifestyle factors that need to be considered, such as whether or not you are a competitive athlete, or if you have any medical conditions. Some of the common treatments for plantar fasciitis include:
- Shockwave therapy: which stimulates blood flow, tissue regeneration and recovery, and provides fast pain relief from plantar fasciitis
- Stretching: usually in the calf muscles, which reduces strain on the plantar fascia, providing pain relief and long-term prevention of recurrence
- Custom-made orthotics: which touch the arch and provide control and support, unloading the plantar fascia and allowing it to heal naturally
- Strapping techniques: to help support the arch of the foot and unload the plantar fascia
- Footwear: your sports podiatrist may recommend a particular type of shoe that will be appropriate for supporting and controlling the arch of your foot correctly.
Your sports podiatrist may also recommend that you apply an ice pack to the area on a dailt basis or after exercise, to reduce inflammation. Anti-inflammatory drugs are not generally recommended, or only as a last resort in very painful cases, as they tend to mask the problem rather than helping to heal the underlying condition.
Please be aware that the information stipulated in the article above regarding plantar fasciitis is intended for educational purposes only and should not be taken as general medical advice. If you are experiencing heel pain or suspect that you may have plantar fasciitis, you should consult with an appropriately qualified sports podiatrist. Appointments can be made online at https://sydneyheelpain.com.au/book-online/ or by phoning (02) 93883322.
Podiatrist
Rami Ghorra
Written by Karl Lockett, Sports Podiatrist