Before we introduce you to what plantar fasciitis is, we need to familiarize you with some elements of the anatomy of the foot and more specifically what the plantar fascia is and where it is located.
The plantar fascia is a thick connective tissue, also called aponeurosis or extensor fascia. It is located at the base of the foot, starting at the patella and extending forward to the base of the metatarsal bones, thus connecting the heel to the forefoot. The main function of the plantar fascia is to support the arch of the foot and absorb load, helping you walk as well.
Having clarified what plantar fascia is, we will turn to one of the most common orthopaedic problems affecting this aponeurosis, namely plantar fasciitis.
We mentioned that the function of fascia is related to absorbing the load of walking, running, jumping, etc. However, in some cases, at high loads, the high stress on the extensor can cause mild damage and tears to the tissue. The body's normal response in cases of traumatic tears is an inflammatory process, that is, inflammation of the fascia at the site where the tear occurred occurs. This inflammatory process results in pain in the heel area, as well as stiffness and rigidity at the base of the foot.
What exactly is the cause of the occurrence of this pathology is not yet fully understood. There are studies that consider the idea of the presence of degenerative changes in the tissue as the cause of these lesions.
The main complaint of plantar fasciitis is pain localized at the base of the heel, which may extend to the midfoot. It usually affects one foot but can affect both simultaneously.
Pain develops gradually over time. It can be dull or sharp. Some people experience a burning pain on the underside of the foot that spreads from the heel to the middle of the foot.
The pain is usually stronger in the morning, when you take the first steps after getting up or if you have rested for a longer time. Climbing stairs may be difficult because of stiffness in the heel area.
After prolonged activity, pain may increase due to increased irritation of the affected area. People who suffer from plantar fasciitis usually do not experience pain during motor activity, but rather after it has ended.
Home treatment includes rest, ice placement and the use of various splints and braces. This is also usually the first treatment approach when such a problem is present. If these measures do not relieve the complaints other treatment options are taken.
Administering a corticosteroid injection directly into the area of the injury to control the inflammatory process is another method that is undertaken by orthopaedic surgeons. However, it should be noted that corticosteroid injections carry certain risks and side effects.
Physiotherapy is one of the key agents used to treat plantar fasciitis. Gentle stretching exercises can be used for the plantar fascia and for the Achilles tendon. Exercises are also used to strengthen the musculature of the lower limbs, which helps to stabilise gait and reduce the strain on the fascia.
If the pain persists and does not respond to some of the applied methods, shock wave therapy may be included in the treatment. In this therapy, a controlled explosion is applied that creates a sound-shock wave. The main therapeutic effect is mechanical. By treating the problem area with the Shockwave device, micro-traumas are induced which form local pseudo-inflammations. These processes improve the blood circulation in the treated area, induce regeneration and regenerative process.
Slight stretching exercises can help relieve pain and in some cases prevent the onset of plantar fasciitis. The muscle groups targeted by the effect of stretching are the hamstring muscles (calf muscles) as well as the plantar fascia itself. This relaxes the musculature, which also reduces tension in the heel area.
It is also important to take a break from some more strenuous activities such as running to give the affected tissues time to recover. During this period, you can incorporate another sport that puts less strain on the inflamed tissue, such as swimming. Once back to running, start gradually, don't overexert yourself by embarking on running a half marathon on the first day.
It's a good idea to include stretching before your workout as part of your warm-up. You can also include it during the workout, between some exercises, to avoid causing pain again.
It's important that your shoes are comfortable and have good support for the arch of the foot. If you're a running enthusiast, it's a good idea to replace your running shoes with new ones every 600-800 km.
Include other types of exercise that are gentler on your feet - swimming, cycling. You can alternate running with any of these sports to avoid overloading the plantar fascia and avoid subsequent complications. Try to include stretching exercises for the calf muscle, Achilles tendon, and plantar fascia before you start with the workout.
At Okto Specialist Physio and Kinesiotherapy Clinics, we have quality equipment and qualified specialists to help you manage pain and inflammation so you can return to your daily activities safely and soundly.
We strive to advise our patients on how to eliminate bad habits that aggravate the current condition and which exercises would lead to an improvement in symptomatology.
You can book an appointment with our specialists here. We are waiting for you!
