What is the plantar fascia?
The plantar fascia is a connective tissue band under the arch of the foot which provides support to the foot structure and aids with the stepping motion whilst walking.
Every step we take is endured by our muscles, tendons, ligaments, and bones. When everything is working in synergy we can function without pain and tolerate large stresses placed upon our feet.
Various circumstances can lead to the plantar fascia becoming overloaded which can lead to changes in the structure and health of the tissue. These changes can present as thickening, inflammation and, in some cases, tearing. The term “fasciitis” means inflammation of the fascia, but most cases are more of a degenerative change in the tissue structure rather than inflammation.
Once these changes have taken place, the resilience of the tissue to absorb load becomes impaired which can negatively affect the function of the plantar fascia and foot, often resulting in pain.Generally, pain from the plantar fascia is felt in the base of the heel or, less commonly, the arch of the foot.
There are multiple causes and risk factors for plantar fasciitis so an accurate assessment is needed to determine the correct treatment for the individual.
Predisposing factors for developing plantar fasciitis include:
- Improper footwear especially thongs
- Walking on soft or uneven surfaces e.g. beach
- Being overweight
- Weakness in the intrinsic muscles of the foot
- Poor forefoot flexibility
- Tight and weak calf muscles
Experience in treating plantar fasciitis
Over years of working with PF injuries, MWE therapists have collaborated to develop a structured approach to tailor treatment based on the multiple variables that are unique to the individual. These variables include factors such as age, foot position, injury timeline, exercise status, and overall health. When factoring in all the variables it becomes clear that no two injuries are ever the same.
The flowchart below, developed by experienced therapists John Olsen and Paul Michael, demonstrates some of the principles for the management of plantar fasciitis and heel pain.
Returning to normal activity
Plantar fasciitis can be a frustrating and stubborn condition that makes it very uncomfortable to stand, walk and run. With the right advice, you can navigate this condition with minimal effect on your quality of life. Once assessed, your therapist can advise you on the appropriate ways to stay active during your rehabilitation, even if this does mean reducing the total number of steps in the day. As your injury recovers you can progress with gradually increasing levels of loading to the heel until you return to normal. Don’t let plantar fasciitis get in the way of your health and wellbeing.