Plantar fasciitis will typically present as a progressively worsening, localised pain on the underside of the heel. It will typically worsen with weight bearing activity to the point where walking is painful. It can result in changes in the bone structure of the heel with the formation of a ‘heel spur’. Plantar fasciitis is usually the result of increased strain on the plantar fascia, which acts to structurally support the underside of the foot and is integral in walking and running mechanics. This overload will result in excessive stress at the insertion of the plantar fascia (where it attaches on the heel) and chronic stress at this point will result in the bone reinforcing itself by laying down more bony material, hence the formation of a spur.
Plantar fasciitis is typically the result of
- Poor pronatory control. For those people with increased pronation, poor medial arch support, combined with increased exercise load, will result in increased strain on the plantar fascia.
- Tight calves will increase tension on the plantar fascia.
- Tight hip flexors will reduce ability to use gluteals in ‘push off’ phase of stride, hence increasing the work load on the plantar fascia and calves.
- Reduced gluteal and hamstring strength will again increase the demand on the calves and plantar fascia, predisposing to overload of these structures.
To achieve resolution of this condition or just as importantly to ensure its prevention, it is important to address:
- Footwear - appropriate shoes for your foot type and ensure to replace them regularly as most shoes are designed to last for about 500km – 600km of running.
- Orthotic shoe support if necessary.
- Ensure good flexibility of calves and hip flexors either through regular stretching or massage.
- Ensure appropriate strength and endurance of gluteals and hamstrings.
- Self massage of the plantar fascia, using a golf ball, will also be beneficial.
- Assessment by a medical professional (physiotherapist/podiatrist), and treatment if necessary, would be warranted if condition is not resolving.
Also anticipate that the more chronic the condition, the gradual will be the recovery and return to sporting activity.
