What is Plantar fascia?
The ligament at the bottom surface of our feet is called plantar fascia.
The attachment of it is from bottom of the heel bone, through which it fans forward towards the toe bones. Inflammation of the plantar fascia is called as plantar fasciitis.
Heel pain and subsequent plantar fasciitis is a commonly encountered foot problem.
It can happen in any age group of people.
What causes plantar fasciitis?
- History of chronic heel pain.
- Sudden heel pain due to overexertion on the foot.
- Acute Ankle sprain.
- History of recurrent ankle sprains.
- Lack of ankle joint mobility & stability.
- Presence of heel spur below the heel bone.
- Improper foot and ankle biomechanics.
- History of wearing ill-fitting shoes.
- Prolonged use of heels or wrong-sized shoes.
- Calf pain history and subsequent ankle immobility.
- Weakness of intrinsic muscles of the foot.
- Chronic presence of heel spur leading to prolonged friction over the plantar fascia.
- History of fracture of any bone that is a part of the foot complex.
- Congenital flat foot / pes planus.
- Adult acquired flat feet issue.
- Strenuous activities like running or walking for prolonged time.
- Improper foot biomechanics.
Other systemic causes:
- Peripheral neuropathy due to diabetic foot.
- Rheumatoid arthritis.
- Degenerative osteoarthritis.
How is heel pain a major indicator of plantar fasciitis?
- Heel pain is the predisposing factor that could lead to plantar fasciits.
- Presence of heel spur below the calcaneal heel bone/ behind the heel bone (close to achilles tendon) is a common cause of heel pain.
- Heel spur is a bony growth near the attachment point of the plantar fascia with the heel bone.
- often the friction of it over the fascia and intrinsic muscles of the foot are a cause of pain, especially during weight bearing activities like walking, jogging, running, squatting or prolonged standing.
Symptoms:
- Dull aching pain below the heel during movements which involve weight-bearing. Eg: sit to stand movement or early morning pain where body weight is put on the heel during the first few steps after getting out of bed.
- Sharp pain under the heel if the pain is acute.
- Burning sensation under the foot with prolonged weight-bearing activities.
- Occasionally numbness or tingling in the foot’s bottom surface.
- Limping while walking in case of severe pain.
Management:
- Ice pack application.
- Plantar fascia stretching & ultrasound therapy under the guidance of a Physiotherapist.
- Foam rolling of the plantar fascia.
- Strengthening of the foot and ankle muscles.
- Footwear evaluation and foot assessment to address flat foot or high arched foot via orthotics.
Dr. Janhvi Vayada – Clinical Sports Physiotherapist
