Each stride causes the connective fibrous plantar fascia tissue to expand and contract several thousand times a day. Through this simple repeated motion, the fibrous band of tissues on the bottom of the feet can overload or experience repetitive strain. It may be weeks – and into months – before the expansions and contractions cause tiny microtears in the fascia that are weaker and more prone to inflammation. As the tears become more frequent and inflammation intensifies, heel pain may become chronically unbearable and turn into a more serious injury if left untreated.
Plantar fasciitis may be a painful condition, but it can be treated effectively through traditional physiotherapy and adjunctive technologies such as Extracorporeal Shockwave Therapy. Before we get too ahead of ourselves in the treatment of this common musculoskeletal condition caused by an “inflamed” plantar fascia ligament, let’s look at some of the root causes of heel pain.
What Causes Plantar Fasciitis?
Plantar fasciitis is commonly referred to as “chronic inflammation.” However, this is misleading. The reality is that the pain is caused by collagen degeneration at the medial calcaneal tubercle – the half-bone closest to the heel – which is why you experience dull or sharp pain in the heel. Rather than inflammatory cells (typically seen in acute tendinopathies), fibroblast cells responsible for collagen degenerate through overload, strain, and the repetitive impact that creates the microtears.
Some common conditions and issues that can lead to plantar fasciitis include:
- Overpronation When the heel’s outer edge first makes contact with the ground and the foot rolls inward, flattening the arch in your feet. This creates strain on the muscles and tissues
- Stress on the ligament If calf muscles are too tight and fail to support the foot
- Obesity or sudden weight gain For example, from pregnancy, can lead to heel pain from the weight the body has to compensate to carry
- Prolonged standing When you bear your weight on hard surfaces for most of the day
- Repeated impact Sports such as running can cause microtears
Your body movement and how you step does directly impact your musculoskeletal health. Explore how physiotherapy can benefit foot and ankle pain.
Plantar Fasciitis and Running Injuries
Runners have a 10 percent chance to develop plantar fasciitis in their lifetime, especially young male athletes. Progressively the pain becomes more prominent and more frequent, especially in the morning as soon as your feet hit the ground. The discomfort caused by collagen degeneration disappears through normal movement as tissues warm through the day. However, following long, sedentary bouts – for example, sitting or standing – the dull or stabbing pain will return.
Plantar fasciitis can be treated effectively with the following:
- Shockwave Therapy to promote cell growth and collagen synthesis
- Plantar fasciitis stretches for the toe and foot arch exercises
- Taping to alleviate stress by inhibiting movement
- Molded individual orthotics
The first step to successfully tailor a treatment plan is to address your personal risk factors that may cause and exacerbate your plantar fasciitis. Plantar fasciitis may be attributed to anatomical issues like overpronation or excessive tibial or femoral anteversion. In athletes, the most common cause is simply the overuse of the ligament through the increased weight-bearing activity from running, which causes trauma beyond our body’s capacity to heal from the degeneration of repetitive movements.
If you’re just beginning to experience symptoms, plantar fasciitis can be fixed more quickly. The shorter the period between the onset of initial pain and when you seek treatment makes a difference in the healing process. Left untreated, the condition can become not only debilitating for a runner but oftentimes demoralizing too. As one of the most common injuries afflicting about a third of runners, seeing a physiotherapist who treats musculoskeletal sports injuries with shockwave physiotherapy each day is an important consideration when selecting a healthcare practitioner to get you back on your feet faster.
By combining both traditional and the latest therapies, HelloPhysio’s physiotherapists can help relieve plantar fasciitis pain and reactivate cell growth to promote collagen synthesis in the heel so that you can return to running and training without the constant stabbing or dull pain. Contact us today to arrange a session with a senior physiotherapist to discuss a targeted plantar fasciitis treatment plan.