The plantar fascia is a band of thick tendon that originate from the calcaneus (heel bone) and inserts into the base of the toes. Its most important function is via the windlass mechanism whereby the plantar fascia tightness as we lift our toes up during gait and thus lifts our medial longitudinal arch.
And plantar fasciitis (PLAN-tur fas-e-I-tis) ?
Pain at the heel of the foot is most prevalent but it can be felt anywhere along the length of the fascia. It used to be thought of as an inflammatory condition but research has shown that it is a series of micro tears, breakdown in collagen and scarring that occurs due to overuse.
What causes plantar fasciitis occur?
- Being overweight or a recent weight gain. More weight equals more force through our arches.
- Diabetes. Impaired peripheral circulation and circulation can result in overloading on the fascia.
- A recent change in amount of time spent standing/walking.
- Weak intrinsic muscles of the foot. The intrinsic foot muscles help to support our arch and plantar fascia.
- Heel striking during walking/running. Heel striking increases the stretch pressure on the calcaneal insertion of the plantar fascia.
- Flat feet. Lower arches means increased downward pressure and pulling on the fascia.
- Tight calves. In younger people the fibres of the plantar fascia link up with those of the Achilles tendon, this connection lessens with age. Therefore tight calves can influence the pull on the plantar fascia.
What can be done about it?
- Reduce the amount of time weightbearing. In the first stages of recovery increasing the amount of time spent sitting compared to standing is the most effective way to relieve pain and allow the plantar fascia to heal in the short term.
- Modify the predisposing factors. Tight calves? Too much activity? Flat feet? Your physiotherapist will help you to address why exactly this happened in the first place and treat you accordingly.
- Strengthen up. Evidence shows that strengthening up the small muscles of the foot and ankle can improve the arch and take pressure off the tendons and joints of the foot. Your Physiotherapist can prescribe specific foot strengthening exercises for you to incorporate into your weekly regime.
- Get more supportive shoes. Research is yet to show a definitive type of shoe that will work best for different foot types, some people may have strong enough intrinsic muscle
and arch strength to wear minimalist shoes whereas some people may need a thicker softer sole. The evidence has clearly shown however that that the number one priority is that we feel our shoes are comfortable throughout the day. If yours aren’t, change them!
- Use biomechanical aids to help through the pain before your plantar fascia is healing. Your Physiotherapist may prescribe arch inserts, kinesiotape or other alternative therapies.
If you have foot or heel pain contact us to make an appointment with one of our therapists today.
Robinson Rd (+65) 62222451
Guthrie House (+65) 63144440
Danielle is an Irish Physiotherapist working in the Robinson Road branch of City Osteopathy and Physiotherapy. Danielle has a keen interest in gait and running injury assessment and retraining. She is a 10-21km distance runner herself and so appreciates the importance of taking care of your feet!