By Inge Kriek
Physiotherapist at Life Ready Physio Rockingham
Plantar fasciopathy, which you may also know as plantar fasciitis, is an overuse condition of the plantar fascia at its attachment to the calcaneus (heel bone) in the ankle. Your plantar fascia stops the over flattening of the arch in your foot and when there is extra stress or load placed through the fascia, plantar fasciopathy may follow.
Signs and symptoms
- Sharp intense pain underneath the heel and arch of the foot
- Pain with the first few steps after waking up (referred to as “first-step pain”)
- Pain after standing up, getting out of the car or resuming walking after rest
- Pain decreases with activity – only to return post-activity with an ache
- Mild swelling in the heel
Causes
There are two common groups of people who are most likely to develop plantar fasciopathy.
- Runners who increase their training load too much too quickly, putting the fascia under increased load
- People with an increased BMI (>30), especially those who spend a lot of time on their feet during the day as the extra load increases the stress on the plantar fascia
However, being a runner and having a greater BMI are not only the causes for developing plantar fasciopathy. Other risk factors that may predispose a person to plantar fasciopathy include:
- Foot position – changes in the arch of the foot (either flat feet or high arch) can change the way the plantar fascia absorbs load
- Training volume – an increase in load or training volume often seen in runners, ballet dancers and aerobics
- Standing work – a job that has a person standing on their feet all day
- Flexibility and strength – muscle fatigue can cause excess stress on the plantar fascia
Management
Treatment for plantar fasciopathy is always dependent on an individual’s presentation and lifestyle factors. Common physiotherapy treatments include:
- Techniques to reduce muscle tightness – dry needling or soft tissue massage
- Strengthening program
- Foot mobilisation
- Plantar fascia and calf stretches
- Fascial release
- Taping of the foot (low-dye)
- Education on activity modification
- Provision of foot orthoses or heel pads
The good news
Plantar fasciopathy has a good success rate with physiotherapy treatment, with over 90% of people improving over a 2-3 month period.
Contact your local Life Ready physiotherapist if you believe you may be experiencing plantar fasciopathy!
