What is Plantar Fasciitis?
The plantar fascia is described as a thick fibrous bands of
connective tissue that originates from the medial aspect of the heel through
the sole of the foot and inserts at the base of each toe. It is a shock
absorbing bowstring supporting the arch of the foot. For
runners the plantar fascia can be a source of major discomfort causing stabbing pain at the
base of the heel and aching throughout the arch of the foot. It affects the
push off mechanism of the foot and produces pain during push off phase while
running. It can also cause stabbing pain in the morning during the first
few steps getting out of bed.
connective tissue that originates from the medial aspect of the heel through
the sole of the foot and inserts at the base of each toe. It is a shock
absorbing bowstring supporting the arch of the foot. For
runners the plantar fascia can be a source of major discomfort causing stabbing pain at the
base of the heel and aching throughout the arch of the foot. It affects the
push off mechanism of the foot and produces pain during push off phase while
running. It can also cause stabbing pain in the morning during the first
few steps getting out of bed.
Plantar fasciitis was originally thought to be an inflammatory
condition but recent research has found it is non-inflammatory breakdown of
tissue as a result of repetitive microtrauma and the name of the condition may
eventually be renamed to plantar fasciosis. There
are also studies discussing the tension on the flexor digitorum brevis and its
resultant forces on the plantar fascia contributing to plantar fasciitis pain.
condition but recent research has found it is non-inflammatory breakdown of
tissue as a result of repetitive microtrauma and the name of the condition may
eventually be renamed to plantar fasciosis. There
are also studies discussing the tension on the flexor digitorum brevis and its
resultant forces on the plantar fascia contributing to plantar fasciitis pain.
Diagnosis of plantar fasciitis would be tenderness to touch along
the medial aspect of the calcaneus (heel bone) on the soul of the foot.
Tenderness can also be present along the medial arch when palpating the edge of
the fascia. The condition is also accompanied with tightness in the calf or
Achilles causing a decrease in Dorsi flexion. Strength of the flexor digitorum
brevis can also be a factor. In one third of all plantar fasciitis patients,
the condition is bilateral.
the medial aspect of the calcaneus (heel bone) on the soul of the foot.
Tenderness can also be present along the medial arch when palpating the edge of
the fascia. The condition is also accompanied with tightness in the calf or
Achilles causing a decrease in Dorsi flexion. Strength of the flexor digitorum
brevis can also be a factor. In one third of all plantar fasciitis patients,
the condition is bilateral.
While plantar fasciitis is thought to be caused by being flat
footed, and flat footed runners have higher occurrence rates, it is not
clinically proven that fallen arches are predisposing factor. Runners of all
arch height can be affected by this condition.
footed, and flat footed runners have higher occurrence rates, it is not
clinically proven that fallen arches are predisposing factor. Runners of all
arch height can be affected by this condition.
Treatment
Treatment of plantar fasciitis can come in many forms. There is
strong evidence supporting manual therapy including self-mobilization of the
ankle joint and toes as well as self-soft tissue mobilization of the plantar
fascia itself.
strong evidence supporting manual therapy including self-mobilization of the
ankle joint and toes as well as self-soft tissue mobilization of the plantar
fascia itself.
Stretching of the gastroc as well as Soleus components
of the lower extremity also have strong supporting evidence of improving
plantar fashion conditions. Stretching of the sole of the foot by
pulling the great toe back is another treatment technique that is supported by
strong evidence.
of the lower extremity also have strong supporting evidence of improving
plantar fashion conditions. Stretching of the sole of the foot by
pulling the great toe back is another treatment technique that is supported by
strong evidence.
For those runners with significant morning pain, night splints
have also proven to be successful in reducing plantar fasciitis pain. Foot
orthoses with a supportive arch are also clinically proven and have strong
evidence of improving this condition.
have also proven to be successful in reducing plantar fasciitis pain. Foot
orthoses with a supportive arch are also clinically proven and have strong
evidence of improving this condition.
Other external treatment alternatives which have good supporting
evidence are anti-pronation taping of the plantar aspect of the foot as
well as kinesiotaping of the arch of the foot.
RockTape shows an example below:
evidence are anti-pronation taping of the plantar aspect of the foot as
well as kinesiotaping of the arch of the foot.
RockTape shows an example below:
Strengthening of the flexor digitorum brevis will also help in the
treatment of plantar fasciitis conditions. Different ways to perform
strengthening exercises for the flexor digitorum brevis include a simple
exercise such as picking up rocks or marbles with your toes or trying to
scrunch a towel or pick up a hand towel with your toes.
treatment of plantar fasciitis conditions. Different ways to perform
strengthening exercises for the flexor digitorum brevis include a simple
exercise such as picking up rocks or marbles with your toes or trying to
scrunch a towel or pick up a hand towel with your toes.
Prevention
While treatment of plantar fasciitis is a good thing to know,
knowing how to prevent it in runners is probably more important. Changes to
increase mileage to quickly as well as increase in hill training are common
flaws that can lead to plantar fasciitis conditions. Making sure you have good
ankle joint flexibility to perform Dorsi flexion as well as well stretched
lower extremities and a strong flexor digitorum brevis will also help prevent
this annoying condition.
knowing how to prevent it in runners is probably more important. Changes to
increase mileage to quickly as well as increase in hill training are common
flaws that can lead to plantar fasciitis conditions. Making sure you have good
ankle joint flexibility to perform Dorsi flexion as well as well stretched
lower extremities and a strong flexor digitorum brevis will also help prevent
this annoying condition.
Watch the video for some self-help treatment techniques…
Blog post by T.C. Cleary.
About
T.C. Cleary PT DPT SCS
T.C. is a member of the Cape Cod Rehab
Running Team not because she enjoys running herself, but because she is one of
the select few PTs in Massachusetts to be Bard Certified in Sports Physical
Therapy. An ice hockey player and coach, T.C. particularly enjoys working with
high school and college athletes. She believes in treating everyone the way you
would want your child or mother treated and employs many different
interventions to obtain maximum recovery. T.C. also has special interest in
Anterior Cruciate Ligament (ACL) Injury Prevention & Treatment along with
Concussion Management.
Running Team not because she enjoys running herself, but because she is one of
the select few PTs in Massachusetts to be Bard Certified in Sports Physical
Therapy. An ice hockey player and coach, T.C. particularly enjoys working with
high school and college athletes. She believes in treating everyone the way you
would want your child or mother treated and employs many different
interventions to obtain maximum recovery. T.C. also has special interest in
Anterior Cruciate Ligament (ACL) Injury Prevention & Treatment along with
Concussion Management.
