Plantar Fasciitis

Definition:

Plantar Fasciitis is defined as the inflammation or degeneration of the plantar fascia, a thick band of tissue that runs along the bottom of the foot, connecting the heel bone to the toes. This tissue acts as a natural shock absorber and supports the arch of the foot.

Causes:

The primary cause of plantar fasciitis is repetitive strain and micro–tears to the plantar fascia. Common contributing factors include:

• Overpronation: Flat feet or arches that collapse inward.
• High Arches: Insufficient shock absorption.
• Tight Calf Muscles/Achilles Tendon: Increased stress on the fascia.
• lfitting footwear: Lack of arch support or cushioning.
• Sudden increase in inactivity: Too much stress on the feet too quickly.
• Obesity: Increased load on the plantar fascia.
• Prolonged Standing: Occupations requiring long periods on one’s feet.

Clinical features:

Plantar Fasciitis typically presents with specific clinical features:

• Gradual Onset: Pain usually develops over time.
• Unilateral Pain: Most characteristic symptoms are severe with the first steps in the morning or after a period of rest.
• Pain after Activity: Worsens after exercise, not during.

Signs & Symptoms:

The hallmark signs and symptoms include:

• Sharp, stabbing Pain: Localised at the bottom of the heel.
• Tenderness to Touch: Particularly at the inner part of the heel.
• Stiffness: Especially after inactivity.
• Pain Worsens with Weight-Bearing: Especially on hard surfaces.

Physiotherapy Management:

• Stretching Exercises: Targeting the plantar fascia, calf muscle, and Achilles tendon.
• Strengthening Exercises: For intrinsic foot muscles and ankle stabilisers.
• Manual Therapy: Soft tissue mobilisation and joint mobilisations.
• Taping/Orthotics: To support the arch and reduce stress.
• Activity Modification: Advice on reducing aggravating activities.
• Footwear Advice: Recommendations for supportive shoes.
• Night Splints: To keep the foot in a dorsiflexed position overnight.

Conclusion:

Plantar Fasciitis, while painful, is a highly treatable condition. Early diagnosis and consistent adherence to a physiotherapy program are key to successful recovery and preventing chronic heel pain. Consulting a healthcare professional for a proper diagnosis and personalised treatment plan is always recommended.