Plantar fasciitis can be a painful condition, affecting approximately 2 million Americans each year. It is a very common condition, affecting active and sedentary individuals alike. Often, patients report onset of pain in the bottom of the heel and foot when they begin a new exercise routine or start to increase walking or running distances in their existing exercise regimens. As many of us are walking more lately to stay active while social distancing, let us talk about plantar fasciitis.
What is plantar fasciitis?
The discomfort experienced with plantar fasciitis is related to irritation of the plantar fascia, a thick band of connective tissue located at the bottom of the foot. The plantar fascia runs from the bottom of the heel bone and connects to the toes at the ball of the foot. An important structure of the foot, the plantar fascia helps with shock absorption during walking and helps to support the arches of the foot while weight bearing. When irritated, the plantar fascia often becomes painful along its connection to the heel bone and may become most painful after a period of inactivity. Patients with plantar fasciitis often complain of significant pain with the first few steps out of bed in the morning for this reason.
What are the risk factors for plantar fasciitis?
Several risk factors have been identified that can contribute to development of plantar fasciitis.
- A stiff ankle joint, especially with dorsiflexion movement (raising the foot upwards), leads to abnormal movement in the lower leg and arches of the foot, in turn straining the plantar fascia.
- High body weight also increases the forces placed on the arches of the foot and may lead to symptom onset, especially in non-athletic individuals.
- Finally, runners and individuals with occupations that involve prolonged standing or walking on hard surfaces may also be at increased risk for development of plantar fasciitis.
How is plantar fasciitis treated?
Effective treatment of plantar fasciitis depends on identifying and addressing the factors that may be irritating the foot.
- Ankle joint stiffness is a common impairment and can be addressed with stretching and joint mobilization exercises.
- Weight management can be a great strategy for long term improvement.
- Research has shown strong evidence in favor of using custom or over the counter shoe orthotics to help reduce discomfort; if considering an over the counter model, look for a brand that offers arch support along the inner foot and a cushioned heel to absorb shock.
- Shoe rotation and anti-fatigue mat use may help reduce discomfort during the work week in individuals who stand or walk for prolonged periods at work.
- Finally, icing the foot can provide temporary relief.
Plantar fasciitis can be challenging to treat, leading many people to delay formal treatment for many months. Physical therapy can be effective in managing and overcoming plantar fasciitis, as physical therapists are trained in identifying and addressing abnormal gait patterns and movement dysfunction within the foot, ankle, and leg. While skilled physical therapy treatment utilizing manual techniques can be very effective in addressing plantar fasciitis, this may not currently be desirable for individuals adhering to social distancing protocols. In this case, a full assessment and treatment protocol can be taught over telehealth to allow for treatment without close personal contact.
To schedule call your local clinic, or our telehealth line at (914) 787-7022. Anyone living in Pennsylvania can book a telehealth appointment specifically with Eric by calling 610-821-9135.
Eric Fontaine, PT, DPT
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