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A pain in the foot: what you need to know about plantar fasciitis

pt Health Pain Relief, Physiotherapy

Plantar fasciitis, often thought of as heel pain, is one of the most common causes of foot pain and will affect nearly 10% of all people at some point in their lives. While most people experience pain in the heel, others can have discomfort under the arch of the foot. Pain from plantar fasciitis can prevent you from running errands, going for walks with family, or even performing full duties at work.

Without treatment, foot pain can be challenging to overcome.

Lifemark’s Heather Cirone, physiotherapist and certified pedorthist and Nirali Mehta, physiotherapist, recently discussed plantar fasciitis, factors that may lead to foot pain, and how intervention can help reduce pain, improve daily function, and prevent recurrence in a free webinar.

Below are 5 key takeaways from this session. To learn more please view the webinar above.

1. The plantar fascia is like the string on an archery bow, applying too much strain can cause inflammation and pain.

The plantar fascia is a thick band of tissue that connects the heel of the foot to the toe. Similar in structure to an archery bow, the bones of your foot make up the bow and the plantar fascia is the string connecting both ends of the bow together. The plantar fascia’s primary role is to support the arch of the foot. Adding pressure downwards onto the foot (bow) will cause the plantar fascia (string) to tighten as it gets stretched to maximal length along the bottom of your foot.  Repeated or excessive loading of the plantar fascia can cause microtears which can lead to inflammation and pain. Similar to the string on the bow, the plantar fascia’s function also includes acting like a spring-type mechanism where it helps the foot push off or move the body forward during activities like walking, running, or jumping.

 2. Reduce your risk of developing plantar fasciitis by addressing lifestyle factors.

As we age, the plantar fascia becomes less elastic and adaptable, increasing the risk of injury. Despite this, there are factors we can modify to reduce our risk of developing plantar fasciitis.  Addressing controllable factors such as weakness, muscle tightness or imbalance of other body structures like the ankle, knee, calf, hip, or core can reduce your risk of developing foot pain.  Extra strain on the plantar fascia from increased body size, being on your feet all day, or choice of footwear, are additional factors that can be modified to help reduce risk.

3. By modifying your activity, you can keep doing what you love.

Rather than stopping all activities or taking a full rest approach, it is often recommended that individuals with plantar fasciitis continue movement to decrease or change the load on the plantar fascia. Small changes such as walking instead of running or taking breaks if you’re on your feet for a long while can make a big difference when dealing with plantar fasciitis. You may also consider trying a new or different, lower-impact activity while you recover. Inactivity and immobilization can worsen the condition and hinder recovery.

4. At-home strategies can help reduce pain and facilitate healing. Try different techniques to see which works for you.

Rotating between applying ice and heat may help promote healing by increasing blood flow in the area. One method is to apply heat for 30 seconds and cold* for 10 seconds and repeat the cycle a few times. Rolling a frozen water bottle or a spike ball with the bottom of your foot can help reduce pain by reducing tension and inflammation in the area. A key strategy in the management of plantar fasciitis is the use of supportive footwear.  It is generally best to choose supportive shoes with a low-to-moderate heel, thick soles, and good arch support with extra cushioning. Limit the use of flats or barefoot walking as this puts higher levels of strain on the plantar fascia. To help promote and speed up recovery, the keys are to stretch the foot to lengthen the plantar fascia and control pain and irritation.

5. Healthcare professionals like physiotherapists can help when self-management isn’t enough.

A healthcare professional such as a physiotherapist or chiropractor conducts a full, individualized assessment, examining how surrounding body structures and/or activities are contributing to your condition. They will work with you to determine the root cause(s) of your issues and provide you with an individualized treatment plan to help resolve your pain and prevent recurrence. Treatment strategies may include manual therapy, a customized exercise plan, acupuncture and shockwave therapy.  Taping is another treatment strategy that involves wearing special tape around the foot and ankle to help offload the plantar fascia and provide support for the arch of the foot. This may help to reduce irritation of your condition while keeping you active and providing pain relief.

Experiencing pain in your foot? See how a ptHealth clinician can help.

* Some individuals may lack temperature sensitivity. Prior to doing this technique, please apply a cloth between your skin and the frozen or hot item and consult with your healthcare provider if this is safe for you.  Never apply ice directly to the skin, always use a cloth or other barrier.

This blog originally appeared on Lifemark.ca and was written by Krista McIntyre, Physiotherapist and National Director of Program Development, Specialty Services.

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