Plantar fasciitis (PF) is a self descriptive condition. Plantar refers to the sole of the foot. Fascia is the tissue that sits between muscle and skin, and -itis suggests inflammation. Except, recent research has found that the condition is not actually inflammatory. Although the name sticks, we take it with a pinch of salt.
Signs and Symptoms of Plantar Fasciitis
PF is characterised by pain in the sole of the foot, just around the heel and spreading up the medial arch. It can be particularly painful first thing in the morning when first putting weight on the foot. Pain typically reduces throughout the day, but may remain present constantly. As a result, high impact demands like running might be harder to carry out, but there may be ways to make it more manageable.
The original onset is often gradual, without an obvious injury or specific cause. Although it might develop following a change in habit, such as increasing your exercise. The less sudden any exercise changes are, the better. If you’re looking to run a marathon in the future, give yourself as long as possible to build up your training. Wearing dramatically different shoes, such as flip flops or high heels could also play a role.
Figures
- 10-15% of the population will develop PF at some point
- most cases develop between the ages of 25-65
- having flat feet or high arches can be a risk factor
- poor foot mechanics are also linked to PF
- higher BMI may be a risk factor
Prognosis
Plantar fasciitis is notoriously long lived, often lasting more than a year, even with treatment. Most cases last at least 6 months, but only 10% of cases need anything more invasive than conservative treatments like osteopathy. When pain lasts for more than six months, it can become more complicated. The more you understand about your pain, and the more control you feel you have over it, the better your prognosis. Things like taking charge of your exercises can be helpful from both a PF perspective, but also from a pain science perspective. If you can find ways around the pain to allow you to continue doing the things you enjoy, that will really help too.
Management
An osteopathic approach to PF will typically involve:
- considering the mechanics of the whole foot and ankle
- ensuring calf tension has minimal impact on the plantar fascia
- looking for patterns of compensation throughout the leg and lower back
You’re likely to go home with some exercises to keep your progress up too. Things like massaging the sole of the foot, or even freezing a water bottle to use as a foot roller can be helpful. If the ankle and calf are quite involved, exercises for those areas can help to speed things along too. In some cases, it might be beneficial for you to also see one of our foot care practitioners alongside your osteopathic appointments. This will be discussed at your appointment if appropriate.
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