The plantar fascia (PF), a thick band of tissue that connects the heel to the toes, plays an important role in absorbing and dissipating the high levels of stress and strain that we put on our feet, writes Chartered Physiotherapist at the arena clinic, Joe Normoyle.
Normally, it does this very well. However, it can become irritated, which leads to stiffness and pain. This is referred to as plantar fasciitis and is the most common type of heel pain.
Plantar fasciitis can be caused by increased stress placed on the PF due to a change in activity or in activity levels. For example, if we spend more time standing, walking or running, we increase the risk of developing PF pain. A change in footwear sometimes can lead to symptoms; sandals and flip-flops are notorious for causing plantar fasciitis.
It typically presents as increased pain and stiffness located directly under the heel and/or slightly to the inside of the heel. Patients commonly report that it feels like they are walking with a stone in their shoe. For most patients the pain is at its worst in the morning, with the first few steps immediately after getting out of bed being most painful.
Once the PF has ‘warmed up’ the pain reduces, however, it usually returns later in that day. This pattern is the same during exercise. A patient, for example, may report pain when starting to walk/run that settles after 5-10 minutes, then returns that evening or is worse the next morning.
First line treatment for plantar fasciitis typically consists of:
- Stretching: Calf muscles (Gastroc & Soleus) and PF stretch.
- Strengthening: Start with double leg and progress to single leg calf raises as able.
- Rolling: Foam roll calves, Roll foot on tennis ball or Sliotar.
- Wearing supportive shoes
Google the above exercises if unsure how to perform them. All exercises should be relatively pain-free; there may be some discomfort during or after the exercises but it should not increase your pain levels significantly. If it does, reduce the number of repetitions or the intensity of the exercises.
It is important to keep exercising in these challenging times. If plantar fasciitis is affecting you during or after exercise, try the exercises above to see if they help reduce your symptoms. If symptoms persist, contact the team at the Arena Clinic for a physiotherapy consultation.