Why does your heel hurt? 2 factors that cause Plantar Fasciitis.
Plantar Fasciitis is one of the most common causes of symptoms for heel pain in runners and is usually categorised by a sharp pain particularly in the morning that warms up or reduces with walking or running. At the Injury Rehab Centre our Physiotherapists and Osteopaths in Cheltenham see many presentations of Plantar Fasciitis every week. About 10% of Plantar Fasciitis cases are linked with running and incidence peaks for individuals between 40-60 years of age.
Why is it happening to me?
Plantar Fasciitis like many other repetitive stress injuries occurs when there is too much load for what the body can tolerate. This repetitive stress causes micro trauma in the Plantar Fascia that is constantly irritated from time spent walking or running in activities of daily living. The foot faces repetitive strain from deformation of the arch during running with landing forces up to three times body weight with every step and this may lead to the development of Plantar Fasciitis.
Am I at risk?
The following factors have been identified in the research as being major risk factors for Plantar Fasciitis.
Reduced ankle dorsiflexion range of motion
Obesity (BMI > 30 kg/m2)
On feet majority of workday
Amongst Runners:
Use of racing spikes
High Foot Arch/Varus Hindfoot
High frequency of running days per week
Increased running volume km’s/week
Years of running activity
Inefficiencies in running form
What are the common symptoms that I might get with plantar fasciitis?
Pain with first steps in morning or after inactivity
Throbbing, searing, or piercing pain located on arch / inferior heel
Walking on toes, barefoot, or upstairs may make you worse
Pain will often ease up after period, but may get worse with continued activity
Is there anything that I can do?
Therapeutic intervention should consist of consulting a Physiotherapist or Osteopath to assess, treat and train any underlying dysfunctions or discrepancies causing the Plantar Fasciitis.
Studies examining the foot’s musculature in individuals with Plantar Fasciitis tend to display a decrease in:
Toe Flexor Strength
Foot Intrinsic muscle strength
These muscles are important as they provide DYNAMIC arch support of the foot during propulsion of gait in running.
Exercises to help Plantar Fasciitis should focus on evening up the ledger between how much stress and strain is being put through the body whilst increasing the tolerance of the Plantar Fascia and the body as a whole to these stresses.
A simple exercise that you may want to try to increase the local capacity of the muscles of the foot is the Foot Shortening Exercise or “Arch Doming” exercise: (See figure)
Keep toes in neutral position and attempt to not bend or extend the toes of your foot while contracting the arch. This exercise will take PRACTICE in order to get good at and you may experience some cramping in your arch, which is a good sign that you are activating these intrinsic muscles.
Perform this exercise multiple times a day with sets of 10 repetitions.
What’s my prognosis if I already have it?
The odds are in your favor! 80% of individuals who have Plantar Fasciitis had resolution of their symptoms in 12 months. However to get the best possible outcomes with your recovery a strategic approach to addressing causative and maintaining factors needs to be implemented. Patients should expect a recovery time of 6-12 months to make full resolution with Physiotherapy and Osteopathy management.
What should I do if I start noticing heel pain sticking around after a week or two?
Don’t delay. The earlier you can begin management to address Plantar Fasciitis with a Physiotherapist or Osteopath the better your outcomes in treatment with be.
The reasoning for this is likely the repetitive nature of the sport where little issues can then cause more stress and strain becoming painful over time.
Particularly if you are a runner our Return To Running Program has a comprehensive history taking and assessment process going above and beyond what other clinics do, so we can identify the root cause of your running related injury. This process is equally applicable to non runners with Plantar Fasciitis and utilises the latest technology including:
M.A.T Assessment created by the therapists of the Injury Rehab Centre to laser focus on areas of flexibility, balance and movement that identify whether your are at risk to sustain an injury.
Slow Motion Running Gait Video Analysis to IDENTIFY YOUR BAD RUNNING HABITS that stop you from progressing that next step in your running.
Strength Testing to identify any strength discrepancies that have a huge role in increasing your injury risk.
Force Plate Technology to put a number on differences in the power you can generate through each leg that can lead to compensations and can cause repetitive stress injuries.
Traditional Physiotherapy and Osteopathy examinations to identify dysfunction.
Next our treatment process achieves pain relief in the shortest amount of time by using hands on Physiotherapy and Osteopathy techniques such as soft tissue massage, joint manipulation, articulation and stretching techniques including the use of the True Stretch system.
Finally your management plan will involve an individualised training plan to build your running/walking movement capacity (muscle and tendon strength, stamina, specific flexibility) as well as increasing your movement skill to make you more efficient out on the road, track or trail to bullet proof your body from injury and increase performance.
Don’t delay. Contact the Injury Rehab Centre to get back on track to resolving your heel pain today. Call our friendly reception on 95537024 or book your appointment online by clicking the link below!
References:
Buchbinder, R. Plantar Fasciitis. New England j med; 2004, 350;21: 2159-2166.
Cole, CC, Seto, CS, Gazewood, J. Plantar Fasciitis: Evidence-Based Review of Diagnosis and Therapy. American Family Physician; 2005, 72 (11): 2237-2242.
Di Caprio, F, Buda, R, Mosca, M, Calabro, A., Giannini, S. Foot and lower limb diseases in runners: assessment of risk factors. Journal of Sports Science and Medicine (2010) 9, 587-596.
McKeon PO, Hertel J, Bramble D, et al. The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med 2015;49:290.
Riddle, DL, Pulisic, M, Pidcoe, P, Johnson, RE. Factors for plantar fasciitis: matched case-control study. The Journal of Bone and Joint Surgery; 2003, 85(5):872-877.