An update on plantar fasciitis

The most common cause of foot pain in runners is from a condition called plantar fasciitis. It can be a severe sharp pain in the sole of the foot just on the heel bone. It is a chronic degenerative condition that is brought about by excess training and is often associated with biomechanical abnormalities such as flat feet and tight calves.

Your foot can be quite stiff and sore first thing in the morning and get painful when you walk or run. Your foot can get so sore that you have to stop running.

The plantar fascia is a piece of connective tissue that comes off the heel bone and runs up the sole of the foot into the toes. It adds structure and support to the sole of the foot and allows force to be transmitted from the calf, through the foot into the toes.

What causes plantar fasciitis?

It is thought that the condition develops much like a tendinopathy, with degeneration and breakdown in the collagen at the base on the heel, there can also be small tears in the fascia and the development of bony heel spurs the more chronic the condition becomes.

There are a number of treatment options available for plantar fasciitis. The first line of treatment should be deep soft tissue work into the calf muscle and plantar fasciitis itself, this should be accompanied by stretching of the plantar fasciitis and calf muscle that can be done at home. You can also do some self-myofascial release work of the plantar fascia at home with a tennis ball or golf ball. As with other tendinopathies the next thing that needs to be done is to strengthen the calf and planter fascia, this is best achieved by doing isometric strengthening exercises to begin with.

It may take two or three months of physiotherapy and home stretching and strengthening exercises to see any change in your symptoms. You can also try taping techniques that can offload the irritated plantar fascia or but a silicone gel heel pad that you can wear in your shoes to cushion the painful area. If after a prolonged period of treatment you are still suffering from here pain there are a couple of options available to you.

Treatment for plantar fasciitis

The first one you could do is to sleep with a Strasberg sock this is a special sock that pulls the foot and toes towards the shin, stretching the calf and plantar fascia overnight. You could also be referred to a consultant orthopaedic foot and ankle surgeon for some shockwave therapy or a steroid injection.