Plantar Fasciitis is the Latin term for "inflammation of the plantar fascia". The plantar fascia is a thick, fibrous ligament that runs under the foot from the heel bone to the toes. It forms the arch of the foot and functions as our natural shock-absorbing mechanism. Unlike muscle tissue, the plantar fascia is not very elastic and therefore is very limited in its capacity to stretch or elongate. Herein lies the problem: when too much traction is placed on the plantar fascia (for various reasons) micro-tearing will occur, resulting in irritation, inflammation and pain.
Plantar Fasciitis usually causes pain under the heel. However some people may experience pain under the arch of the foot. Both heel pain and arch discomfort can be related to Plantar Fasciitis, with heel pain being far more common than arch pain.
Stage 1 (0-2 weeks)
- soft tissue releases and maintenance aimed at reducing tightness in the calves
- correct any misalignment of the knee, hip or pelvis
- prescription of correct application of ice principles - 15 minutes after exercise
- activity modifications to prevent aggravations
- use of strapping or orthotics to reduce inflammation
- possibly start on stabilising the arch of the foot with exercises
Stage 2 (2-4 weeks)
- introduction of evidenced based strength training - physio will prescribe to you the correct exercises based on your individual assessment
- continue with stage 1 treatment as needed
Precautions in the first 4 weeks or longer
- avoid prolonged standing
- avoid long walks, running, training unless cleared
- avoid dynamic sports unless advised
Stage 3 (4-8 weeks)
- Progression of rehabilitation
- Work on further concentric and eccentric loading
- discuss return to gym and other activities
Stage 4 (8-12 weeks)
- Work on high end dynamic strengthening exercises for full return to sports and work
When should I see improvements?
Most patients will start to see some reduced pain the first 2-3 weeks but this time can vary depending on the severity of the injury how long you have left it to seek treatment and if we were able to follow through the whole treatment plan without any set backs.
How long will it take to get back to normal?
Once the pain has reduced you may consider that you are back to normal and finish treatment.
However, the pain has reduced only as the inflammation has subsided.
The healing in the plantar fascia is slow due to a poor blood supply in the area and this can take anywhere from 3-6 months for a structural repair, again this depends on severity and compliance.
Performing the correct retraining of the muscles surrounding area inline with current research will see your injury rehabilitated to its potential.
This gives you the best chance of managing the injury in the long run. If not completely rehabilitated the fascia can re-tear when you return to full activities.