The plantar fascia is made up of a strong fibrous band that starts at the heel bone and passes through to the forefoot. It provides support to the bottom of the foot and acts as a shock absorber during activity.
Plantar fasciitis is frequently described as foot pain that can be felt at the heel or along the arch and ball of the foot. You may also hear it referred to as heel spur syndrome. It is actually an inflammation of the plantar fascia that first becomes irritated and then later inflamed.
The main symptom is pain on the bottom of the foot or heel that is usually at its worst upon rising and increases over a period of months. People describe the pain as being very intense when they get up in the morning and take their first step or after they have been sitting for long periods of time. After a few minutes of walking the pain often decreases because walking stretches the fascia. For some the pain subsides but returns after spending long periods of time on their feet.
Factors that contribute to the development of plantar fasciitis include:
- Over 40 years of age
- A job, sport or hobby that involves prolonged standing or weight bearing activities
- Rapid increases in length or levels of activity such as a new exercise program or new job that requires standing for longer periods of time
- Decreased calf muscle flexibility (tight heel cord)
- Excessively high or flat arch
- Walking barefoot or in shoes with poor support
Physical therapists are trained to evaluate and treat plantar fasciitis. Physical Therapy may include one or more of the following: modalities, stretching, strengthening exercises, taping, instrument assisted soft tissue mobilization (Graston Technique), and other manual techniques and modalities.
An individualized exercise program will be provided to meet each patient’s specific needs. Instruction in a home exercise program will be given initially and modifications will be made throughout the course of therapy. Stretching of the plantar fascia, Achilles tendon and hamstring will be incorporated into the treatment plan and should be performed before getting out of bed in the morning to decrease the symptoms of the first step in the morning. Kinesio Taping may be applied and left on between treatment sessions to reduce the stretch and stress on the plantar fascia, especially with weight bearing. During Physical Therapy, various modalities including phonophoresis and iontophoresis may be used to drive topical corticosteroids into soft tissue structures. Restricted activity and regular icing will help with the pain and are often incorporated into the regime.
In conjunction with Physical Therapy other treatments may be prescribed from a physician such as injections, casting, night splints, medications, orthotics, and laser therapy. Surgical intervention is a treatment of last resort if all else fails to alleviate the pain.
Research shows that most cases of plantar fasciitis will improve over time with conservative treatment. Please consult the experienced Rehab Connection Physical Therapists to address your individual needs and answer any questions.