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UNDERSTANDING YOUR FOOT PAIN : PLANTAR FASCIITIS

Updated: Sep 15, 2023

Do u feel a pricking pain in your foot or around the heel ? The first few steps in the morning feel the most painful ?


Or does your heel hurt after long hours of standing?


Well then, this blog is for you.


The symptoms mentioned above are similar to a condition known as plantar fasciitis. To know how to get rid of it, let’s first understand about the condition.



What is plantar fasciitis ?


Plantar fasciitis is a common foot condition characterized by inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of your foot, connecting your heel bone (calcaneus) to your toes. This condition can be quite painful and is a leading cause of heel pain in adults.



plantar fascia

What happens around Fascia ?


Plantar fasciitis is often characterized by micro-tears or degeneration of the plantar fascia due to excessive stress or repetitive strain.


If untreated inflammation will continue which will eventually led to calcium deposit.


Eventually Calcium deposits accumulate and harden, forming a bony protrusion or spur on the heel bone (calcaneus). This is often referred to as a "heel spur" or "calcaneal spur."


It is important to understand that not everyone with plantar fasciitis will develop calcification or a heel spur, and the presence of a spur does not necessarily correlate with the severity of symptoms. Many people with plantar fasciitis experience pain and discomfort without the presence of a visible heel spur on imaging studies like X-rays.



How does the pain start?


Pain due to plantar fasciitis could be because of various reasons :


  1. A sudden increase in activity levels (intensive walking or running).

  2. Flat foot or high arch foot.

  3. Increase in walking, standing, or running on hard surfaces.

  4. Uncomfortable footwear or change in footwear.

  5. Increase in body weight.

  6. Sedentary Lifestyle can cause weakening of the muscles in the lower extremities. Weakened muscles do not provide adequate support to the arch of the foot thereby leading to Plantar Fasciitis.

  7. Deconditioning also causes muscle weakness thereby leading to reduced arch support and increase in foot pain.



Symptoms of Plantar Fasciitis: -

  1. Gradual Increase in pain.

  2. Pain felt typically near the heel.

  3. The pain can be sudden, occurring after missing a step or jumping from a height.

  4. The pain tends to be the worst when you get up in the morning or after periods of inactivity.

  5. The degree of discomfort can sometimes lessen with activity during the day or after warming up but it can become worse after prolonged or vigorous activity.

  6. The pain may also appear more intense in bare feet or in shoes with minimal support.


How Physiotherapists can help in the diagnosis


Assessment: The assessment includes evaluating range of motion, muscle strength, and footwear for stiffness, muscle imbalances and unevenness respectively.


Assessing proximal joints like knee, hip, pelvis & Lower back is also important. Poor postural alignment can alter gait and weight distribution, potentially leading to plantar fasciitis.


Plantar pressure analysis: It can assess how the foot functions during weight-bearing activities. It can also help identify issues such as overpronation (excessive inward rolling of the foot) or supination (insufficient inward rolling) that may impact the plantar fascia.


Gait Analysis: Plantar pressure analysis can provide insights into an individual's gait (walking pattern) and how they distribute pressure across their feet while walking or running. In the context of plantar fasciitis, it can help identify abnormal biomechanical patterns that may contribute to the condition.


Orthotics Assessment: Once diagnosed with plantar fasciitis, monitoring the changes in pressure distribution and gait mechanics can help prescribing interventions like orthotics or footwear modifications to improve the progress of condition along with physiotherapy.


Posture Assessment: A detailed assessment of foot, knee, and hip alignment is crucial, as abnormal mechanics can exert a significant impact on foot health.



plantar pressure analysis

Treatment options:


Pharmacological Treatment: It includes Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), Muscle Relaxants, Corticosteroids, Plasma Rich Protein, Pain Relievers Medications.


Physiotherapy Management:


1. To reduce excess pressure on the Plantar Fascia, it can be beneficial to identify abnormalities within the kinetic chain and subsequently undergo retraining with the help of physical therapy exercises.


2. Foot wear modification: Proper footwear can help reduce strain on the plantar fascia, provide support, and promote healing.


3. Ultrasound: It can help in relieving your pain, inflammation & tissue healing.


4. Strengthening: It will help in enhancing shock absorption, muscle stability & provide appropriate support to the foot.


5. Stretching: It relieves tension and tightness to improve overall flexibility.




Steps to Prevent the condition before it becomes chronic


Stretching


Stretching is important to prevent plantar fasciitis because it helps to maintain flexibility and mobility in the muscles, tendons, and ligaments of the foot and calf.


Insoles


Insole supports the arches of foot, providing support to the necessary areas. It prevents overloading the plantar fascia and helps with efficient movement.



Strengthening


Maintaining good muscle strength and balance prevents straining the plantar fascia and prevent the occurrence of the condition.


Strengthening your plantar fascia enables runners to achieve efficient shock absorption, allows housewives to stand for extended periods comfortably, and enables ballet dancers to dance without irritation.








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