Plantar Fasciitis

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What is Plantar Fasciitis?

We use our feet constantly throughout the day – whether it be while we are standing, walking, running, participating in sports or even climbing up stairs. Our feet bear the weight of the entire body, so it is not uncommon for them to be subjected to overuse type injuries. Under the foot is a thick layer of tissue called the plantar fascia that acts like a support mechanism to the arch of the foot. Irritation, injury or inflammation of the plantar fascia is commonly known as plantar fasciitis (sometimes spelt Plantar Fascia -itis) but is more correctly named plantar fasciosis. …in this article we’ll discuss plantar fasciitis further and explore the various approaches to Plantar Fasciitis treatment.


What Causes Plantar Fasciitis?

Plantar Fasciitis is a condition caused by a multitude of different mechanisms and in most cases a combination of factors. Common factors know to contribute to the development of plantar fasciitis include poor foot posture, poor footwear, obesity, recurrent trauma, training errors or over-training, excessively tight muscles and prolonged weight-bearing. Plantar fasciitis is commonly seen in athletes, especially those who train with inappropriate footwear. This can result in altered foot mechanics, causing the foot to excessively roll in or out which can place undue stress on the plantar fascia resulting in plantar fasciitis. Plantar fasciitis may also be seen in elderly patients due to the loss of the protective fat layer around it.


Symptoms of Plantar Fasciitis

Patients who suffer from plantar fasciitis commonly complain of pain in the heel that is at its worst after a period of rest – e.g. When they first get up in the morning or after a period of sitting. It is often aggravated after a period of exercise or standing. And the pain can extend to the entire plantar section of the foot and can cause difficulty walking. In patients who suffer from plantar fasciitis the pain can be reproduced on stretching the toes and ankle upwards or by applying pressure on the heel.



Plantar Fasciitis Treatment

There are a number of different approaches that can be adopted in treating plantar fasciitis.

  1. Conservative treatment
    This includes rest, taping, icepack application, massage, stretching and changing to more appropriate cushioned and supportive footwear. In most cases this treatment is sufficient to help relieve symptoms.
  2. Drug treatment
    This involves taking painkillers such as non-steroidal anti-inflammatory drugs. However in some cases, steroid injections may be required into the plantar fascia which can provide a period of relief from symptoms. Steroid injections do not treat the underlying cause of the plantar fasciitis and should be seen as pain management rather than ‘fixing’ the problem. A detailed assessment including ultrasound of the area will be performed prior to injecting steroids.
  3. Physical therapy
    This can include a variety of exercises and muscle stretches prescribed by a Podiatrist or Physiotherapist that can help reduce pain and inflammation. Physical therapy usually includes massage and potentially the use of dry needling.
  4. Orthotic therapy
    Your Podiatrist may prescribe orthotic devices to correct your foot mechanics if they are deemed to be a contributing factor to your plantar fasciitis. Appropriately prescribed orthotics can minimize the strain on the plantar fascia improving symptoms and reducing the risk of future injury.
  5. Extracorporeal shock wave therapy
    This treatment uses shock waves to eliminate ‘substance P’ which is involved in the sensation of pain. This treatment can be very painful and requires multiple treatments but can helpful in long standing cases of plantar fasciitis.
  6. Surgical treatment
    This is very rarely offered as in most cases plantar fasciitis recovers with conservative treatment options. Surgical methods include a procedure called a fasciotomy which involves splitting the fascia, thus reducing the tension within it. Surgical treatments have a good success rate but require rehabilitation post surgery.



Robert Harvey (AFL Footballer)

Robert Harvery mentioned on the Football Show (Channel 9) how he jumped off a table in his kitchen in an attempt to rupture his plantar fascia (yes – for the purpose of plantar fascia treatment!). This was in an effort to avoid surgery and ensure that he could recover quickly and play in the upcoming finals series. Note – this is not the recommended treatment strategy for our patients with plantar fasciitis.



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Plantar fasciitis can be a troublesome problem which can cause difficulty walking. A number of plantar fasciitis treatments (or plantar fascia treatment) are available but conservative management appears to be the best way forward. If you are concerned about your foot problems and think you may be suffering from Plantar Fasciitis, please call our clinic and arrange a time for diagnosis and treatment. Plantar Fascia -itis