Plantar Fasciitis: Causes + Treatments
By Athletico Physical Therapy
Are you suffering from pain at the bottom of the heel? It is important to identify when symptoms occur, where they occur and what the symptoms feel like in order to classify the pain as plantar fasciitis (PF).
Common PF symptoms include pain with initial steps in the morning, pain with steps after prolonged rest and pain that is relieved with activity. Many patients wonder, what is causing these symptoms and why are they occurring? Also, how can physical therapy to help relieve these symptoms? Discover the answer to these questions below.
What Causes PF?
The biomechanical alignment of the lower extremities and/or a flat foot (decreased/flattened arch) places increased stress on the plantar fascia. This typically results in pain at the inner heel surface. Approximately 10-20 percent of injured athletes can be affected by PF, but only 5-10 percent progress to surgery.3 This shows that conservative treatment is ideal to initially treat PF. However, conservative treatment can take up to 6-18 months to completely resolve a patient’s symptoms.3
There are three bands of the plantar fascia (which are absent in 12 percent of individuals3), that go to the outer aspect center and inner area along the arch of the bottom of the foot. The central band is the major component of the plantar fascia that reaches into the base of the first through fifth metatarsal phalangeal joints, which connects toes to the foot.3 Importantly, the plantar fascia assists in supporting the arch in standing. Research shows that the plantar fascia is typically activated during heel lift. This movement causes the toes to be flexed back toward the body, increasing the stability of the plantar fascia to assist in supporting the arch.3
It is important to note that there are mechanical factors that put someone at risk for getting PF. One factor is stiffness in various areas within the boney complex of the foot. Changes in the mobility or structure of the bones that make up the foot can lead to a decreased arch and decreased ankle range of motion. Another factor that can lead to these symptoms is a tight Achilles complex because the plantar fascia and Achilles tendon are connected by a small structure called the paratendon and are in close proximity to each other. Unsupportive foot wear, over use and obesity may also play a role in symptoms associated with PF.1
Related to the mechanical factors listed, there are a variety of physical therapy techniques that can help. One of these techniques is joint mobilization, which assists the bones in gliding in the appropriate direction if they are not moving enough or are considered stiff (hypomobile). Recent research also shows that strength training of the Achilles tendon can be transferred to the plantar fascia.2 This may assist in increasing the tensile strength of the plantar fascia to prevent it from being susceptible to degenerative changes or weakening of the fascia, which makes it prone to having a tear. Although there are various ways to strengthen, it is recommended to have the guidance of a physical therapist to ensure you are using proper body mechanics and increasing the load safely.
If you think you are having symptoms of PF, please consult your doctor and see if physical therapy may be a good option in order to restore the normal function of the foot/ankle in addition to the overall strength of the lower extremities. Then request an appointment at an Athletico near you!
-Athletico Physical Therapy
A note from Chiappetta Shoes:
In addition to physical therapy and daily exercises, painful symptoms of plantar fasciitis can be alleviated and prevented by wearing good-quality footwear. Your feet are your foundation, and therefore being proactive and taking preventative measures is ideal; save yourself time and pain by considering your foot health now. At Chiappetta Shoes, we see many current and new customers daily that suffer from painful foot conditions such as plantar fasciitis. All of our sales staff is well-trained in making suggestions to alleviate the painful conditions that occur from this condition. Stop in at your earliest convenience and we can get you in some great quality footwear and help you get back on your feet again. Over 97 years of experience has allowed us to confidently say that we’re fit experts and we understand the biomechanics of the foot better better than most. If you’re suffering with this condition or another, stop in and we can take a look at your feet and provide guidance on footwear, OTC’s, custom inserts, and even daily exercises. Be sure to check out Athletico Physical Therapy in Kenosha if you’re considering physical therapy.
1. Hancock CL, Baker RT, Sorenson EA. Treatment of plantar fascia pain with joint mobilizations and positional release therapy: a case study. 2016; 21 (4): 23-29.
- Rathleff MS, Molgaard CM, Fredberg U, et al. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow up. Scandinavian Journal of Medicine and Science in Sports. 2015; 25: 292-300.
- Wearing SC, Smeathers JE, Urry SR, Hennig EM, Hills AP. The pathomechanics of plantar fasciitis. Sports Med. 2006; 36 (7): 585-611.
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