The plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and extending along the sole of the foot towards the five toes. It has been reported that plantar fasciitis occurs in 10% of the population over a lifetime. It is commonly associated with long periods of weight bearing or wearing the wrong shoes. Among non-athletic populations, it is associated with a high body mass index. Sufferers of plantar fasciitis has an increased probability of suffering knee pains, especially among runners. In athletes, it is usually an overuse injury that causes inflammation of the plantar fascia at its attachment site on the heel. Longstanding cases of plantar fasciitis often demonstrate more degenerative changes than inflammatory changes, in which case they are termed plantar fasciosis.
Plantar fasciitis occurs as a result of stretching and pulling of the plantar fascia from its attachment on the heel bone. Running and dancing are commonly associated with this. It is often an overuse injury. Wearing the wrong shoes, stiffness of the calf muscles and incorrect foot position (decreased foot arch) may also contribute.
The pain is typically worse in the morning with the first steps – some people cannot walk with a flat foot until the area warms up. Pain is also worse with high impact heavy weight bearing activities. The pain is usually felt on the underside of the heel and may extend toward the toes and is usually described as a dull ache. Over time, the inflammation can worsen with activity and the pain can increase. The pain is usually felt on the underside of the heel and may extend toward the toes. Another symptom is that the sufferer has difficulty pulling the foot and toes upwards toward the shin (decreased dorsiflexion of the ankle).
Treatment options for plantar fasciitis include rest, massage therapy, stretching, night splints, motion control running shoes, Cold therapy, orthotics/inner soles for your shoes, anti-inflammatory medications, injection of corticosteroids and surgery in severe cases. Stretching, biomechanical correction, strapping/taping and strengthening are also performed during physiotherapy.