Plantar Fasciitis – Best Foot Forward

[dropcap]D[/dropcap]o you ever wake up in the morning and feel pain in your feet as soon as they touch the ground? If the answer is yes, you could be suffering from plantar fasciitis. Plantar fasciitis is an inflammatory condition that causes stabbing pains in the foot and/or heel and is usually worst first thing in the morning or after sitting or standing still for too long.

So, what is the plantar fascia? It is a thick fibrous band that runs along the bottom of the foot, from the toes to the heels, supporting the muscles and arches. Think of it as a beam that supports the arch of the foot. If the band becomes overstretched, it can cause little tears on the surface, which can cause inflammation.

Both men and women can be affected but unfortunately for the ladies reading this, you are more at risk, as are those who are overweight. So, what causes plantar fasciitis? There is a lot of speculation; to date there is no definite conclusion but some of the most common agreed risk factors are:

• Wearing shoes with a thin sole or walking barefoot

• Wearing high-heeled shoes on a regular basis

• Having tight calf muscles and Achilles tendon

• Being overweight

• Having flat feet or high arches

• Having an unusual walking pattern

• Doing exercises that put a lot of stress through the foot: jumping, high impact aerobics, (long distance) running.

As there is no agreement on the cause of plantar fasciitis, treatment will often be varied and not always effective in relieving symptoms.  Doctors often prescribe anti-inflammatories which, at times, only provide temporary relief. In extreme cases they may suggest a steroid injection or, as a last resort, if the pain is not resolving, surgery.  

Physiotherapists and podiatrists, on the other hand, are excellent at providing relief and offering suggestions during an episode of pain, and can also suggest interventions to minimise further occurrences.

What is physiotherapy and how can it help? Physiotherapy is a healthcare profession that works with people who are affected by injury, illness or disability. It is a science-based profession that takes a ‘whole person’ approach to health and well-being, which includes the patient’s general lifestyle. So whether you are active, sedentary or an athlete, physiotherapists will work with you to achieve pain relief and optimum function without the use of medication.

After a thorough assessment they will plan a unique treatment programme using effective modalities and exercise therapy. Depending on your level of pain and long-term goals your programme may include:

Posture assessment:

Looking at your general posture, lower limb biomechanics and your strength and flexibility.  They will look at the arches of your feet, position of your ankle and your walking pattern and style.

Pain Relief:

One of the most effective pain relief modalities for plantar fasciitis is ultrasound. Therapeutic ultrasound transmits sound waves through the skin.  This produces tiny bubbles that ‘bump’ into each other, acting as a deep massage to reduce inflammation and break down scar tissue. Ice and heat are also beneficial in reducing pain and improving function; depending on the stage of your problem your physiotherapist will advise you on how to use them effectively.

Prescribing exercise:

Weakness and tightness in the muscles around the hips and ankle may also be responsible for your symptoms; strengthening and flexibility exercises play an important role in recovery and prevention.  Your physiotherapist will design a tailor-made programme for you to perform daily at home.

Gait re-education:

The way we walk can also be a factor in the source of pain, or the pain you are experiencing may even change your walking style. Long-term changes in how you walk may eventually affect your hips and knees causing further problems in the future.

These are just some of the ways physiotherapy can help to relieve your pain and improve your function. So, instead of suffering in silence, maximise your potential and seek help and advice to get back on your feet. Pain-free feet are happy feet!

Kim Jackson is a UK-trained physiotherapist with over 20 years’ experience.  She specializes in musculoskeletal pain and dysfunction, including back pain and sciatica, stroke and other neuro conditions plus sports physiotherapy. She has worked with local, regional and international athletes, treating injuries and analyzing biomechanics to improve function and performance.  She is registered with the Allied Health Council and is a member of PASL.  She currently works at Bayside Therapy Services in Rodney Bay. www.baysidetherapyservices.com