Is your heel pain making you crawl out of bed in the morning? Have you purchased new shoes recently? Have you recently increased your running distance, or increased the amount of hills in your training? Perhaps you started running along the beach?
In the arch of the foot we have a broad, fibrous connective tissue that spans from the base of heel bone (calcaneus) and inserts into the toes, called the plantar fascia.
Subsequently, the fascia has a functional role in the arch to provide support when standing still, and dynamic shock absorption when running. In running and other sports e.g. dancing that require the foot to come forward onto the toes (metatarsophalangeal joints), it causes tension in the plantar fascia.
Plantar fasciitis is caused by the repeated overuse of the plantar fascia, which creates tension at the heel attachment (calcaneus), which can lead to increased stress on the bone (and can be associated with calcaneal spurs), and a disruption in the collagen fibers of the fascia.
Point of pain
Pain is usually on inside of the heel, worse in the morning, decreases with activity, and often aches after activity. Periods of rest are generally followed by an increase in pain as activity is recommended.
Conservative Physiotherapy treatment may consist of soft tissue massage, taping techniques, stretches , ultrasound, dry needling, correction of running biomechanics and technique, or motor control correction. Treatment could also include strengthening exercises for the muscles that surround the plantar fascia in the foot, as well as strengthening exercises for the calf and the hip.
Biomechanics correction using orthoses and also footwear selection should also be considered. The most effective treatment is a combined treatment approach that incorporates multiple treatment modalities. In-between treatment: Avoidance of aggravating activities, ice after activity, stretching of the plantar fascia and the calf, self-massage with an ice water bottle or with a golf ball.
