Plantar Fasciitis (PF) is a common and painful condition affecting the connective tissue of the heel and sole of the foot. Unfortunately, injury to the PF results in the inability to put weight through the foot and symptoms typically involve an intense stabbing pain that’s makes unbearable to walk and run. The role of the Plantar Fascia is to help maintain the main foot’s arch and allows for effective to push off every time you step.
Injury to the PF results in the tissues ability to absorb tensile forces meaning that during walking the arch cannot maintain its rigid form and collapses putting further strain on the PF and exacerbating symptoms.
How to treat PF?
PF pathology and symptom presentation is similar to tendinopathy found in the Achilles and Patella tendon. This similarity gives us the framework to treat this painful condition.
Here is the four-step process to treat PF
1. Reduce acute pain by offloading the tension that goes through the PF. This can be done through strapping techniques or temporary express orthotics.
Examples of orthotics and taping
The goal with these treatment options is to immediately reduce the pain and allow you to perform basic activities such as walking without pain. It is not advisable to use these options long term but they are good for modification and reduction of acute PF symptoms
2. Improve range of motion in the Calf/ Soleus and PF. The PF is a continuation of the Achilles Tendon and therefore the structures connected to the Achilles Tendon must have adequate ROM. This can be done through soft tissue release, dry needling and active release techniques.
PF is a continuation of the Achilles Tendon and calf muscle through fascial links
3. Strengthen the PF through specifically targeted exercises so that the PF can firstly tolerate the client’s body weight for walking and secondly prepare the tendon to withstand the tensile forces experienced with running.
We recommend following a stepped exercise programme that starts with isometric holding exercises progressing through to concentric/eccentric calf raises and finally advancing to eccentric exercises to develop calf strength and PF tensile load force.
Examples of progressive strengthening exercises
4. Alter biomechanical factors that could have caused PF overload and irritation in the first place. These include improving big toe mobility, excessive pronation in the foot, hip and lower leg biomechanics when running.
Hip control and effect the stress through the PF and irritate symptoms
PF is a painful condition that needs careful management and a specific strengthening programme. Symptoms can last for months if not treated and will make normal activities such as walking unbearable. At Recovery Room Physiotherapy & Performance we focus on helping our people get back to the activities they really want to do. Contact us to get the right management for this condition.