What is it?
The plantar fascia is a thick, fibrous band of connective tissue that runs under the foot from the heel bone to the toes. Pain is felt when inflammation occurs in this tissue. It is most commonly felt first thing in the morning and going from sitting to standing. If plantar fasciitis goes untreated and inflammation worsens, a heel spur can develop. A spur is the body's way of dealing with the stress and calcium deposits are formed at the attachment point of the heel bone.
Causes:
Plantar fasciitis can be multifactorial in cause but the main reason is stress to the connective band of tissue. Stress is most commonly seen through tight surrounding musculature in the calf and achilles, excessive pronation (rolling in) during gait, limb length discrepancy, weight gain, inappropriate footwear and or trauma. If left untreated, pain often worsens.
Treatment:
Treatment primarily involves reducing the tissue stress, this is done using conservative methods such as taping, strapping and using ultrasound and shockwave therapy. A biomechanical examination is also conducted to assess the contributing factors. Footwear is assessed and if necessary, more appropriate footwear is advised, or further offloading through the use of orthotics is advised. Self management strategies such as stretching, icing and massage are also recommended. Cortisone injections, immobilisation in a CAM boot and surgery are only considered if conservative therapies are unresponsive.