Have you ever felt pain on the inside of your heel?

Is the pain throbbing or stabbing and forcing you to walk on your toes?

Is the pain worse in the morning and gradually getting better during the day?

If so, you may have plantar fasciitis. This is the most common overuse condition that is treated in clinic by our Chiropodist. Poorly managed plantar fasciitis can significantly worsen your quality of life by interfering with your ability to carry out day-to-day activities.

What is the plantar fascia? The plantar fascia is a ligament attached to the heel bone (calcaneus) that divides and fans out to attach at the base of the toes (metatarsals). The plantar fascia covers muscles, tendons, nerves and blood vessels and acts as a bowstring on the bottom of the foot, helping the bones of the foot maintain the arch.

Plantar fasciitis occurs when there is a strain of the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament which can be very painful.

What are the signs and symptoms of plantar fasciitis?   Usually pain is worse with the first few steps out of bed in the morning and also getting up after prolonged sitting. This is due to the fascia becoming very relaxed at rest and once walking, the foot elongates and then re-injures the fascia where it inserts into the heel. Pain is felt with applying pressure to the inside of the heel (where the fascia inserts into the heel bone).

What is the cause of plantar fasciitis?  Many factors can lead to tearing of the fascia. These include an inward roll of feet during gait (excessive pronation), high arches or flat feet, excessive walking, standing, or running, especially on hard surfaces, excessive weight gain over a period of 6-12 months, and tight Achilles tendons or calf muscles.

What are the treatment options for plantar fasciitis? There are multiple treatment modalities for plantar fasciitis. Some of these treatments are icing, stretching, strengthening exercises, shockwave therapy, low level laser therapy, night splints and orthotics.

Custom orthotics are medical devices used in the management of several foot conditions to relieve pain, and to protect and improve the function of the foot. Custom orthotics are used to treat many biomechanical abnormalities that lead to overuse conditions. Many of the treatment modalities listed above will assist in healing the tears in the fascia. However, without correcting the cause of the initial tearing of the fascia, it is likely that the plantar fascia will tear again in the future. Since orthotics can address the root cause of the plantar fasciitis, they are a very effective mid- to long-term treatment for this condition.

Orthotics are made from a plaster cast of the foot in sub talar joint neutral position. This is the position that the foot should be in when in a weight bearing position.  In many cases, plantar fasciitis is caused by inward motion of the foot (out of sub talar joint neutral) that puts strain on the fascia causing microtears to form. Once the foot is placed into the correct neutral position, these tears can begin to heal and the orthotics will also prevent these tears from re-occurring.

With the correct conservative management, the majority of plantar fasciitis cases will resolve within a few months. The longer you suffer with plantar fasciitis and delay seeking treatment, the less likely you will improve from conservative treatment and the more it will affect your quality of life.

If you or someone you know is suffering from heel pain and would like to have a foot assessment to determine the proper treatment for you, call the Carleton Sport Medicine Clinic to book an appointment with our Chiropodist today.