First thought of the morning: the bottom of my foot hurts! My heel hurts! Do you limp when you get out of bed? You are not alone. You may be experiencing symptoms of a foot condition called plantar fasciitis.
Every year, millions of people seek care for this painful condition, especially when it interferes with work or daily activities. Key symptoms include: pain under the foot, particularly at the heel, pain and stiffness with the first few steps in the morning or after resting (laying or sitting) for long periods of time.
“Plantar fascia” is a band of tissue that extends from the heel to the toes. It almost covers the entire bottom (plantar) surface of the feet. It provides arch support and shock absorption. The direct impact from heel strike and the repetitive nature of activities or sports cause microtears resulting in pain and inflammation. “Itis” means inflammation. Therefore, “plantar fasciitis” means inflammation of the plantar fascia, the sheath of tissue under the feet.
Some of the most common causes of plantar fasciitis include repetitive use, standing for long periods on hard surfaces, and injury from running and sports. Approximately 10% of active adults experience plantar fasciitis. However, this condition occurs most frequently in middle-aged adults who are physically inactive and overweight individuals. It is more frequently in women aged between 20 and 40 years of age. In many cases, inappropriate footwear is often the culprit. Those nice high heels can be a real pain!
To be fair to the shoes, the biomechanical factors of the foot also play an important role. If you have flat feet, if your feet turn in, if you have tight calves, if you have a high arch and/or if you have a significant leg length difference… you are predisposed to having plantar fasciitis.
The most important treatment is education! We need to prevent the microtears. Your healthcare professional will discuss key points that are applicable to you including some of the following:
- Proper foot attire
- Avoiding wearing high heel shoes
- Wearing appropriate footwear in the house
- EXERCISES AND STRETCHING:
- Specific exercise techniques
- Warming up before exercises
- Using proper sports-training techniques, especially for runners
- Custom orthotics
- Generic orthotics
- Night splint
- Avoiding sitting and standing for long periods of time
- Using correct posture
- LIFESTYLE CHANGES
- Smoking cessation
- Avoiding or reducing caffeine
- Losing weight
Physiotherapy, acupuncture as well as other forms of care such as massage therapy are beneficial for plantar fasciitis. The outcome of plantar fasciitis with proper care is usually good. Even if there is substantial pain initially, many patients obtain relief with the appropriate care and rehabilitation. Studies show that 95% of cases are resolved within six to twelve months with stretching and education. Stretching of the plantar fascia and Achilles tendon everyday is key. These stretches can be done at home, at work or even on the bus, either sitting or standing.