what is plantar fasciitis?

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Plantar fasciitis (the more accurate name is plantar fasciopathy) is pain that is felt on the underside of your foot, most commonly worse just in front of your heel bone. The pain is usually worse first thing in the morning and when getting up after sitting for longer periods. The pain usually subsides as you warm up into your run but is often wrose afterwards.

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what causes plantar fasciits?

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Plantar fasciitis is a process that is similar in nature to a tendinopathy. When the structure on the underside of your foot cannot cope with the load going through it, it presents with pain. Over time the plantar fascia can have small microdamage (collogen breakdown) and calcification (stiffening of the plantarfascia) which causes it to become less able to deal with absorbing weight bearing forces. New blood vessels and new nerve growth within the plantar fascia are thought to be the main reason the plantar fascia is painful and not the breakdown process of the collagen.

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A stiff ankle joint and stiff big toe joint are often found in patients with plantar fasciitis. Also reduced strength in the calf and the smaller foot muscles can often be found.

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Changing your running style (converting to forefootstriking), a recent change in footware or an increase in your running frequency/intensity can also be the reasons that your plantarfascia pain may have started. Addressing these issues and setting up an appropriate training plan will form an important part of your treatment. Observing you running via slow motion gait analysis video will detect any running technique errors that may need to be addressed as part of your rehabilitation.

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Biomechanical issues are thought to be less of any issue but are an important part to consider once the most important factors have been addressed (strength, training error, running technique).

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treatment for plantar fasciitis

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The most important thing in the early stages is to settle day to day pain. By perfroming regular physio exercises, wearing appropriate footware and modifying your activity helps to settle the acute symptoms. From here it is important to increase the load capacity of the plantar fascia. This comes in the form of gradual strengthening exercises and dynamic exercises that will load the plantarfascia bit by bit. This ensures that you return to running without the problem re-occuring, even as you get back to your desired level of training.

 

Also making changes to your running gait and biomechanics where necessary will all help to reduce the loading forces at the platarfascia and subsequently your pain. Careful management of your running schedule and reintroducing running slowly will be an important factor to ensure the problem does not return.

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