Plantar fasciitis

What is it?

Your plantarfascia is the thick muscles and tendons under the bottom of your foot that connects your heel to your toes and produces the arch in your foot. There are two main causes for pain at the plantarfascia namely a tear or repetitive overload causing inflammation and tendinosis.

How does it get injured?

Tearing the plantarfascia is very uncommon and occurs without any warning due to a sudden force or pushing off. It is predominantly during sports requiring changing direction or sudden acceleration eg netball, touch rugby, sprinting. This sudden force causes the muscle to tear either partially or a full thickness tear.

Plantar fasciitis is a repetitive overload of the muscles and tendons at an uneven angle. This occurs over a period of time and can be caused by a number of biomechanical factors including weak or tight hips, poor footwear, weak or tight calf muscles, flat feet (also known as over pronation), compensating for a previous injury, or a sudden increase in training load.

What does it feel like?

Acute plantarfascia rupture feels like someone has shot you in the bottom of the foot or you have stood on a sharp knife. You are often unable to walk due to pain, weakness or feeling like you cannot push off that foot when walking.

Plantar fasciitis is a gradual worsening of achy pain anywhere along the muscle at the bottom of the foot. Due to the inflammation, you will feel most stiff and sore in the mornings with most pain during the first steps when getting out of bed. It is common to feel better later in the day or after doing short periods of light exercise eg short walks, but the pain can return later in the day once you are resting again. You may notice a gradually increasing swelling or thickness around the painful area.

How are they diagnosed?

Your physiotherapist is likely to diagnose an acute plantarfascia rupture with palpation (feeling the area), determining the mechanism of injury, and eliminating any other causes for your pain. A complete tear may be referred to the hospital for further treatment and investigation. You may be given a casting or moon boot. Plantar fasciitis may also be referred for further investigations, specifically an ultrasound scan which will reveal the extent of the injury. Your therapist will ask questions about your symptoms and how the pain started combined with some basic standing tests and feeling gently around the foot to get a precise diagnosis of the stage and biomechanical cause of tear or tendinosis.

What can Back in Action do to help?

It is essential that the exact cause of overload to your plantarfascia needs to be determined so your Back In Action Physiotherapist will take the time to fully assess you from your lower back all the way to your footwear. Once a comprehensive assessment has been completed they will, together with you, make a rehabilitation plan and discuss necessary modifications for optimal healing. We will use mobilisations, massage and other techniques to encourage decrease of the inflammation and pain at the tendon, tendon sheath and surrounding muscles. We will work with you to lengthen or strengthen the foot and correct biomechanical faults that may have caused the injury, to get you back to health as soon as possible. We will then integrate this into a functional rehabilitation plan so you can confidently return to sport with a reduced chance of recurrence.