plantar fasciitis

Plantar fasciitis is a foot condition that causes pain under the heel. It is mainly a result of overuse of the arch tendon or plantar fascia of the foot.

This article will discuss the causes, symptoms and available treatment.

What is plantar fascia?

The plantar fascia is a ligament that extends from the bottom of the heel to the front of the foot. Its function is to support and maintain the arch of the foot. The plantar fascia plays a very important role in movement. Thus, any injury associated with it can result in difficulty walking and severe discomfort.

Plantar fasciitis was initially classified as inflammation. However, since no inflammatory cells presented within the fascia when examined, this information is now considered incorrect. In some circles they believe this can be attributed to heel overuse which then causes the collagen fibres near the heel bone (calcaneus) to degenerate.

Plantar fasciitis is often compared with heel spur; however, these two conditions are not exactly the same as a heel spur is a bony growth at the calcaneus.

What are the causes of plantar fasciitis?

Plantar fasciitis is common in people with overpronated feet (flat feet or feet that roll inwards). They are the most at risk for this condition as overpronation of the foot results to added stretching of the fascia.

When the calf muscles are too tight, they tend to cause high velocity foot pronation. This leads to repetitive overstretching of the fascia, causing the tendon to thicken. This thickening then causes the plantar fascia to lose its strength and flexibility.

Using footwear that does not provide sufficient arch support is also a cause of plantar fasciitis. Wearing shoes with cushioning and adequate arch support e.g. flat, lace-up shoes is ideal.

People who engage in sports activities that cause great impact to the foot (e.g. dancing, jumping, or running) are also at risk. Excessive and repetitive foot activity, such as running or walking on hard, uneven terrains, can also result in symptoms.

plantar fasciitis

Overweight people are also at risk as the excess weight causes high impact to the foot. Sudden weight gain is another cause.

What are the symptoms of plantar fasciitis?

Plantar fasciitis is usually felt on the inside of the heel, where the attachment of the fascia is located. The symptoms present when the inside of the heel or the arch is pressed. As the fascia tightens up overnight, the symptoms may be worse in the morning when you take your first few steps. The pain, however, gradually alleviates as the foot warms up. The symptoms may worsen throughout the day, especially after intense activity. Tenderness, tightness, or stiffness on the bottom of the foot may also be present.

Treatment

There are numerous treatments available to ease the pain caused by plantar fasciitis, but there is no cure. In order to get long term relief, it is best to know and correct the cause of the condition.

What can you do?

  1. Using a cold or hot pack on the affected foot can lessen the inflammation. Cold therapy is recommended to be applied regularly until the pain is relieved.
  2. Resting until the feet are not painful is recommended. Doing so would be difficult as many people’s work involves being on their feet the entire day; however, forcing the affected foot to walk will aggravate the condition and worsen the inflammation.
  3. Reducing the inflammation may be helpful but it does not provide a long term solution. The fascia may tighten up more, causing the heel to become more prone to stress. Doing plantar fasciitis exercises, like stretching the plantar fascia, is a significant part of the treatment and therefore should be done.

What can your chiropractor do?

  1. Your chiropractor can prescribe anti-inflammatory medication (e.g. ibuprofen) to relieve the pain and inflammation.
  2. Gait analysis can also be performed for the chiropractor to know whether you overpronate or oversupinate, so the proper insoles or orthotics can be prescribed. If overpronation is the cause of the problem, an insole will be helpful in restoring the normal biomechanics of the foot.
  3. Your chiropractor can also reduce the stress and tension on your foot by applying sports massage techniques and calf muscle stretching.
  4. He can also prescribe and teach you the proper exercises to help stretch the plantar fascia. These exercises can also help strengthen the fascia.
  5. Your chiropractor will perform a biomechanical assessment of the foot ankle, knee, hip and low back as dysfunction in any of these areas can put excess stress on the foot. He will treat the joints with mobilisation where necessary.

We regularly treat plantar fasciitis in our chiropractic clinics in Chester and near Llandudno in North Wales.

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