What is Plantar Fasciitis & who does it affect?
Plantar fasciitis also known as plantar heel pain is described as soreness or tenderness in the heel, sole and arch of the feet, with this condition estimated to account for around 8% of musculoskeletal consultations for the foot and ankle pain in general practice.
The prevalence of plantar fasciitis is not fully known, however some population based studies have found it affects around 7% of people over the age of 65 and 4% of the population over the age of 20. This condition affects both athletic and sedentary individuals and is particularly common in runners.
As well as the incidence rate of plantar fasciitis, the reason it occurs is not fully understood, however, there are many contributing factors which may influence the likelihood of developing it, including;
- Being overweight
- Older age
- Periods of prolonged standing
- Reduced range of motion in the ankle and big toe.
- Poor arch support in your shoes
- Tightness in calf muscles
The symptoms of plantar fasciitis are variable but not limited to:
- Pain or tenderness in the heel or arch of the foot
- Pain with initial steps in the morning or after a period of rest
- Walking short distances may improve pain but longer distances may increase symptoms
- Pain with sudden stretching of the sole of the foot (e.g. standing on your toes or walking upstairs)
- Pain with prolonged standing or when wearing flat or unsupportive footwear
How can osteopathy help?
Diagnosis of plantar fasciitis can be achieved by an osteopath via a thorough medical case history and relevant examination. Usually no further investigations are needed to conclude that plantar fasciitis is the cause of your foot pain.
Osteopaths use a variety of different techniques which research suggests may help with the symptoms and reoccurrence of plantar fasciitis including:
- Myofascial release
- Positional release of the plantar fascia
- Trigger point therapy
- Mobilisation of the ankle
- Stretching of the Achilles & Calf muscles
- Spinal manipulation
- Manipulation of the ankle and foot
- Soft tissue technique to the muscles surrounding the foot and ankle.
Exercises for Plantar Fasciitis
Frozen Water Bottle/Ball Release
Freeze a bottle of water and roll underneath the arch of your foot for 5 minutes. Ensure the ice has defrosted a bit before applying it to your foot to avoid ice burn. If you aren’t able to use a bottle of ice, use a tennis or hockey ball to achieve a similar release.
Stretching the Plantar Fascia & Calves
- Place one leg out in front of you and place the ball of your foot against the wall with your heel contacting the ground.
- Place your hands out flat on the wall in front of you.
- Lean forward putting your weight onto the foot in contact with the wall, until you feel a stretch in the sole of your foot and down the back of your leg.
- Once the stretch is achieved hold for 10-12 seconds
- Return to the neutral position (Step 1 & 2).
- Repeat 6 times, twice daily.
Ankle Mobility Exercise
- Kneel on one leg placing your forefoot around 30 centimetres in front of a wall.
- Keeping your foot planted, lean forward placing weight onto your front foot slowly until your knee touches the wall.
- Return slowly to starting position.
- Repeat 12 times on each foot, twice daily.
If you perform these exercises and don’t see any improvement within a couple of weeks, it may be time to call an osteopath.
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Wynne, M. M., Burns, J. M., Eland, D. C., Conatser, R. R., & Howell, J. N. (2006). Effect of counterstrain on stretch reflexes, hoffmann reflexes, and clinical outcomes in subjects with plantar fasciitis. The Journal of the American Osteopathic Association, 106(9), 547-556.
Renan-Ordine, R., Alburquerque-SendÍn, F., Rodrigues De Souza, D. P., Cleland, J. A., & Fernández-de-las-Peñas, C. (2011). Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: a randomized controlled trial. journal of orthopaedic & sports physical therapy, 41(2), 43-50.
Shashua, A., Flechter, S., Avidan, L., Ofir, D., Melayev, A., & Kalichman, L. (2015). The effect of additional ankle and midfoot mobilizations on plantar fasciitis: a randomized controlled trial. journal of orthopaedic & sports physical therapy, 45(4), 265-272.
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Celik, D., Kuş, G., & Sırma, S. Ö. (2016). Joint mobilization and stretching exercise vs steroid injection in the treatment of plantar fasciitis: a randomized controlled study. Foot & ankle international, 37(2), 150-156.
Brantingham, J. W., Globe, G., Pollard, H., Hicks, M., Korporaal, C., & Hoskins, W. (2009). Manipulative therapy for lower extremity conditions: expansion of literature review. Journal of manipulative and physiological therapeutics, 32(1), 53-71.
Landorf, K. B. (2015). Plantar heel pain and plantar fasciitis. BMJ clinical evidence, 2015.