The plantar fascia is a thick fibrous band on the underside of the foot that helps to support the arches and deep muscles of the foot. Often over time, if any stress that is put upon the plantar fascia becomes too much and it can begins to degenerate, causing pain when the foot is placed on the ground.
Plantar fasciopathy is also known as plantar fasciitis and can be notoriously difficult to treat. It is a progressive condition but, in some cases, a self-limiting one. The condition does sometimes, eventually resolve itself. Without treatment, however, the condition can take up to two years to go away and is extremely painful in the meantime.
The first symptoms are a slight pain on the inside of the heel in the mornings; usually the first steps of the day are the most painful. As the condition progresses there may be pain with walking or running. In severe cases pain might be felt all the time, even when resting.
For athletes it is likely that the problem is caused by training program errors, poor biomechanics, tight calves and inadequate support in footwear. In other people, it’s more likely that the problem is caused by standing for long periods on hard surfaces. Other risk factors include age, poor footwear choices and increased weight.
The first stage of treatment will involve diagnosis and identification of contributing factors. Your physiotherapist can apply taping techniques to unload the fascia and use hands on techniques to restore flexibility to the calf muscles and fascia. This can provide great relief of pain, particularly in the early stages of treatment. A specific loading exercise program will be implemented and they will also advise you on a suitable training program, footwear and stretches. They can also help make modifications to your running style if this is contributing to the problem.
There are medical options for heel spur removal, shockwave therapy and steroidal injection however these treatments work best if used in conjunction with traditional physiotherapy.
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None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.
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