Plantar Fasciitis
Plantar fasciitis is a term for inflammation or degeneration of the plantar fascia. The plantar fascia is a dense band of tissue that lives on the bottom of the foot and it acts as both a biomechanical stabilizer as well as a protector for the foot. Plantar fasciitis typically comes from repetitive chronic overload of the tissue that results in a breakdown of the healing process and failure to repair the tissue to a normal state. (1) There are many underlying biomechanical factors that can lead to plantar fasciitis like flat feet or a rigid big toe. Tightness in the calves and hamstring can also lead to increased loading of the plantar fascia and eventually plantar fasciitis. (2) Risk factors for developing plantar fasciitis include working on your feet for a prolonged period of time such as teachers, construction workers or nurses, long distance runner or walkers, rapidly increasing time spent on your feet, increasing running load, or changing surfaces.
The most common complaint of plantar fasciitis is a sharp pain with the first couple steps in the morning or after any period of prolonged inactivity. The pain is the worst when pushing through the foot. Walking up stairs is typically worse than down stairs. Pain is often made better by sitting or lying down. It is often more painful to walk barefoot. The heel is often tender to touch on the inside of it.
Treatment for plantar fasciitis is a multimodal process. Removing activities that make symptoms worse such as running, jumping and sprinting is important. Any foot abnormalities should be addressed with foot orthotics. Night time immobilization can increase the rate of recovery. Mobilization of the joints of the foot and ankle can help restore normal joint motion and mechanics. Stretching and manual release techniques are applied to muscles and tissues that are hypertonic. Rehabilitative exercises are used to increase the strength and endurance of the small muscles inside the foot. (3)
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Martin JE, Hosch JC, Goforth WP, Murff RT, Lynch DM, Odom RD. Mechanical treatment of plantar fasciitis; a prospective study. Journal of the American Podiatric Medical Association. 2001 Feb;91(2)55-62
Bedi HS, Love BR. Difference in impulse distribution patterns in patients with plantar fasciitis. Foot and ankle international. 1998 Mar;19(3):153-6
Michaud T, New Techniques For Treating Plantar Fasciitis, Competitor Group Published Mar. 6, 2014