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Plantar fascitis is an overuse condition of the plantar fascia at its attachment to the calcaneus. The term 'fascitis' is misleading as it suggests that it is an inflammatory condition but the collagen disarray occurs in the absence of inflammatory cells. Therefore a more accurate term would be plantar fasciosis.
Plantar fascitis is generally felt as pain around the inner aspect of your heel bone (medial border of calcaneus). It is often more noticeable for the first few steps following periods prolonged rest e.g. first thing in the morning and generally decreases with activity. A post activity ache around the area is not uncommon and as the condition worsens pain may increase with activity and become noticeable while weight-bearing. The plantar fascia may feel tight and stretching it can exacerbate pain.
The plantar fascia consists of three segments and runs from the calcaneus to the toes to form the longitudinal arch of your foot. Variations of foot type are very common, pes planus (flat feet) and pes cavus (high arches) can both place the individual at increased risk of developing plantar fascitis.
To understand how the condition develops it is first important to understand the role of the foot in locomotion; normal gait involves suipination of the subtalar joint at heel contact, pronation at mid-stance (shock absorption) and re-supination at toe-off. The plantar fascia acts to hold tension in the late stance which helps to stabilise the foot and reduce tension on surrounding structures.
A low arched foot stretches the the origin of the plantar fascia at the calcaneus during toe-off phase whereas immobility in a high arched foot can place strain on the plantar fascia if it is too stiff to absorb shock and adapt to shape of underfoot surface.
Plantar Fascitis is most common in people who engage in activities such as running, dancing or jumping. Increases in the volumes or intensities of these activities can increase risk as can inappropriate footwear, advancing age or inadequate conditioning.
Reduced ankle mobility and tightness of calves, hamstrings and gluteal muscles are commonly seen in individuals with plantar fascitis. Significantly strength of these muscle groups is equally as important; research shows that the individuals with weakness in hip abductor strength (lumbopelvic control) are more likely to develop these overuse injuries including plantar fascitis.
Your Chartered Physiotherapist can diagnose the condition; the next step is rehab where an individualised plan needs to be put in place to facilitate your recovery from this often debilitating condition. The plan may include modification of current training load, assessment of biomechanical abnormalities and movement dysfunctions with prescription of individualised strength exercises to address any arising issues.
Feel free to contact us for an assessment or Functional Movement Screening to enable us to help reduce your risk of injury and enhance your athletic performance.
Kieran Nolan MISCP MSc (SportsMed) Plantar fascitis is an overuse condition of the plantar fascia at its attachment... Read More
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