What is Plantar Fasciitis?
The heel and foot are very common areas to have pain, and a region we treat every day at IPT, but how do we know what is causing it? While there are many potential sources of pain in this area, plantar fasciitis is probably the most common one that we see. You have probably heard of this, but what exactly is it and what can you do about it if you are experiencing this?
Presentation
This is typically felt as pain in the bottom and/or inside part of the heel, also commonly with pain in the arch of the foot. Timing can vary, but this pain is most often felt more with initial steps after periods of inactivity such as after sleeping or sitting at work, but can also be felt after prolonged periods of weight bearing activity such as after a long day on your feet at work. Common risk factors include high BMI, sharp increase in weight bearing or dynamic activity, and poor ankle mobility.
Here are a few things to consider to manage this condition:
Activity Modification
Often symptoms appear after increasing dynamic or weight bearing activity too much, too fast, especially after periods of inactivity such as a runner training after an off-season, coming off an injury, or even starting a new job with physical demands that are newer to you. If you are able to, try reducing activity levels in the short term to reduce the inflammation and aggravating factors. If you are a runner, for example, try reducing pace, distance, or even take some time off to reduce your overall training volume. Consider breaking up standing activities at home or at work to reduce the amount of time you are standing for one period of time if you are able to. You may be able to manage the pain levels and reduce further aggravating it as you are addressing the underlying cause of the symptoms (more on that next). A good rule of thumb to potentially avoid getting back to activities too quickly is to gradually introduce or increase by roughly 10% each week if able. Movement variety is also key to avoiding repetitive or overuse injuries. For example, if you typically go for a walk or run on the treadmill, try mixing in some days outdoors, like at a park or even a hiking trail, or go for a bike ride instead of a run at times, this will expose your body to different surfaces and demands in a positive manner.
Treatment
There are many things to consider regarding this condition outside of activity levels. The foot and ankle are the most directly related to this condition, but areas such as the knee, hip, and trunk all play a role as well, with potential deficits of strength, range of motion, or mechanics creating extra stress on the plantar fascia. With that being said, here are a few exercises that can often help manage this condition that you could try at home:
- Rolling the arch and painful area on a frozen water bottle or tennis ball. Try the water bottle for 3-5 minutes when pain is elevated, and consider the tennis ball when pain is more mild.
- Plantar fascia stretch: stretch by extending the toe like shown in the picture, try working towards a few holds of 30 seconds.
- Towel crunches: try crunching up a towel with your toes for 3-5 minutes to help strengthen the small muscles in the foot that help support the arch during weight bearing.
- Heel raises: standing on a step or ledge, raise up on your toes, then slowly lower the heels down until a stretch is felt in the calves, hold for a few seconds, then return to the top. Try 2-3 rounds of 10 reps, emphasizing the controlled lowering portion.
Exercise is a vital component of treatment of this condition, but other things that may be considered include soft-tissue and joint mobilization, dry needling, orthotics, taping, and various pain-relieving modalities. Of course, we are a little biased, but we recommend seeking evaluation by one of our physical therapists if you are unable to manage these independently after a few days so he or she can determine the true underlying causes and tailor a specific treatment plan to fit your needs. As with most injuries, taking care of things sooner rather than later is your best bet. The longer an injury goes untreated, the longer it may take to resolve and could potentially increase risk for other injuries, but that is why we are here for you!
By Brad Penning, DPT, PT, DN Cert, CBFE – Avon Clinic
About Brad:
I became a PT because as an exercise and sports enthusiast, I have always been interested in learning more about how the human body moves and how to use this to help someone optimize their function and performance. My favorite part about my job is that I truly enjoy getting to meet a wide variety of individuals and help them reach their specific goals. Fun fact about me is that I am married to Taylor who is our Occupational Therapist and we have a small family including our son Kirk who was born in May 2021 and a Corgi named Navy, who each have varying degrees of love for my obsession with Michigan football and smoking meats.
