Plantar Fasciitis

One of the most common causes of heel and foot pain seen in the outpatient setting is plantar fasciitis. It is seen as a result of tightening or inflammation of the plantar fascia.

This fascia is a connective tissue that extends from the base of the heel attaching to the base of the toes and plays a vital role in maintaining the integrity of the arch of the foot, weight bearing and shock absorption. The tension created in the plantar fascia is also crucial in providing stability to the ankle and foot while keeping muscle activity at a minimum.

It is most commonly seen in active working adults and 10 to 20 % of runners also present with heel and foot pain that is attributed to the plantar fascia.

Plantar Fasciitis Therapy

If you are suffering from Plantar Fasciitis, all you have to do is reach out to the nearby expert physiotherapist. It will help you in knowing the causes, risks, and symptoms associated with heel and foot pain.

Getting relief from Plantar Fasciitis is the foremost criterion. Talking to a professional physiotherapist gets to know the detailed understanding of the disease and the procedure performed.

Risks

Most commonly attributed to overuse or repetitive stress injuries, plantar fasciitis can have certain predisposing factors that can stress the fascia, such as

● Limited ankle and foot mobility (in case of fractures of lower limb)

● Obesity

● Foot deformities (such as flat foot, pes cavus, calcaneal spur)

● Impactful activity (such as running, jumping)

● Limb length discrepancy

● Improper shoes

● Diabetic foot

● Tightness in the leg muscles (specifically the calf and foot muscles)

● Occupational load (example teachers who are required to stand for long duration)

Symptoms

● The clinical presentation of plantar fasciitis is most commonly identified as heel pain.

● Since there is an absence of inflammatory cells, the term plantar heel pain helps to cover a wider variety of symptoms that may be attributed the plantar fascia and heel pain.

● The pain is felt when taking the first few steps in the morning or following a period of not walking, and it tends to get a little better with few steps.

● There can also be tenderness or sensitivity to touch that is present at the heel and sometimes the inner aspect of the foot.

● Pain may be worse when walking bare foot on surfaces that are hard and while walking on stairs.

● Toe walking or a limp may be observed due to pain or tightness in the fascia.

● Some patients report a sudden increase in their activity prior to the symptoms.

Tests

An accurate physical examination, patient’s medical history, changes in physical activity and symptoms of foot pain must be considered when trying to diagnose plantar fasciitis.

The therapist or physician should look for tenderness that is present in and around the heel, specifically the inner aspect of the heel following the course of the fascia till the base of the toes.

There would also be pain that is observed when performing passive dorsiflexion of the toes and foot. The windlass test may also be performed in order to confirm the diagnosis.

An X-ray may be recommended to rule out bony abnormalities.

Treatment

First, you need to understand the right Plantar Fasciitis treatment that your physiotherapist is going to provide you with.

Plantar Fasciitis condition responds well to conservative and physical therapy management.

Rest and application of ice along with massage helps in reducing symptoms of pain.

Non-steroidal anti- inflammatory drugs may also be used in severe symptoms of pain.

The therapist would focus on educating the patient with regard to the possible course of this condition and inform the patient that improvement may take weeks depending on the cause of the pain.

The goals of the management will focus on pain relief, stretching, strengthening, manipulation and if required assistive aids may be prescribed.

Pain relief may be achieved by the use of TENS, therapeutic Ultrasound, Laser therapy.

The objective is to promote healing that helps decrease pain in the fascia in and around the heel and foot.

The use of Ice packs, hot packs or combination of both may be recommended depending on the condition of the patient.

Stretching and strengthening is performed for the muscles of the lower limb namely the calf muscles (gastrocnemius and soleus), tibialis anterior and other intrinsic muscles of the foot.

Depending on symptom severity, exercises may be taught to the patient at home or through video consultations but supervision in the initial stages is recommended.

Manipulation or mobilization

Since the plantar fascia is a soft tissue, manipulation techniques such as massage, tissue release techniques would help in restoring pain free function in the foot.

The therapist may also perform joint mobilization to the ankle or foot if there are structural limitations impeding function to the plantar fascia.

Taping is an effective technique that can be performed in order to reorganize the weight being distributed to the foot and minimize the load falling on the fascia which may also help in reducing pain.

Assistive aids

A night splint may be recommended that would help in stretching the fascia and calf muscles that may help in minimizing pain felt in the morning.

Silicone gel-based heel pads that can be used as shoe inserts would also help in shock absorption and reducing pain.

Arch support orthotics could also help in improving mechanics of the foot and may aid in recovery.

Changes in lifestyle such as weight reduction, switching sports (for example, switching from running to swimming or cycling), usage of proper footwear are simple recommendations that can help in recovering from plantar fasciitis.

Conclusion

To get Relief from pain which comes in  Plantar Fasciitis Physiotherapy is the best option, Physiotherapy treatment to your heel and feet will help to reduce the pain and you will be walkable in no time.

If you are suffering from Plantar Fasciitis, all you have to do is reach for the Plantar Fasciitis Therapy Center at PhysioTattva. The services provided by the expert physiotherapists help to reduce the inflammation of the tissue, thus reducing the pain caused by Plantar Fasciitis.

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