Foot Pain Too Much?
Written by Nadine George, Physiotherpist
Plantar Fasciitis is a common overuse condition of the foot that accounts for up to 15% of foot and ankle conditions seen by health professionals. The Plantar Fascia is the strong fibrous tendon made from collagen that attaches from the bottom of your heel to the balls of your feet and is important in the mechanics of walking, running, jumping and landing.
Plantar Fasciitis is the term most commonly used to describe this condition, which is characterised by pain at the bottom of the heel. The pain is often worse when walking first thing in the morning or after prolonged rest, and it usually eases as the tendon warms up with activity. However, we now know that whilst Plantar Fascia pain may feel inflamed and extremely sore, the condition is not actually characterised by inflammation at all.
Plantar Fascia pain is like other tendon paid, it is a result of overuse and overload that slowly results in the disorganisation of collagen fibres. This disorganisation eventually results in the tendon weakening, and as a result, pain ensues as you continue your normal activities. Understanding this means the correct term for Plantar Fascia pain is actually Plantar Fasciosis, “osis” meaning degenerative. As there is no inflammation with this condition, most people find that taking anti-inflammatories such as Voltaren, Nurofen or Advil, or using anti-inflammatory topical gels, doesn’t solve their pain problems.
Treatment for this condition is multifactorial, but ultimately the most important parts of rehabilitation are managing load and strengthening the tendon.
Load can encompass a whole range of activities such as time on your feet, intensity of exercise, how much impact exercise you complete, footwear down to the type of surface walked on. Managing these factors will assist in controlling the amount of strain that goes through the Plantar Fascia and enable you to better control your pain.
Despite implementing these measures, your pain will not improve until the Plantar Fascia is strengthened so that it can better withstand the requirements of your day. Physiotherapists and Exercise Physiologists will be able to provide an individualised strength program to suit your activity requirements and get the best results. Assessment and treatment of Plantar Fasciosis may also involve the following:
- Biochemical analysis of foot posture
- Address any restrictions in range of motion of the foot and ankle
- Analysis of kinetic chain coordination and strength including hip and knee control
- Assessment of footwear
Reference: Tahririan, M.A., Motififard, M., Tahmasebi, M. M., & Siavashi, B. (2012). Plantar fasciitis. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences, 17(8), 799-804.
Posted: 12 July 2018