Understanding Plantar Fasciopathy

What is Plantar Fasciopathy?

Plantar fasciopathy is an overuse injury that typically affects very physically active people such as runners or people with extended amounts of standing work. The plantar fascia is the thick band of tissue that connects your heel bone to your toes. When you push off with your foot to take a step, this band tightens to increase the arch height and create a lever to propel you forward.

Plantar Fasciopathy

Have You Experienced Plantar Fasciopathy

Most of us who have experienced plantar fasciopathy know from first hand experience how debilitating and frustrating it can be. Every morning can feel like walking on broken glass.

The prevalence in the general population is estimated to range from 3.6% to 7%  and may account for as much as 8% of all running-related injuries.

Plantar fasciopathy is a common condition with 1 in 10 people will have plantar faciopathy in their lifetime, and it is most common in people aged between 45 and 65 and is slightly more common in women than men. But anyone can experience it at any time.

Risk Factors:

  • Bow legged 
  • Use of spiked athletic shoes 
  • High foot arch  
  • Sudden increase in load or practice sessions per week 

What Are The Signs and Symptoms?

  • Heel pain, particularly when walking after a long period of inactivity a signature symptom includes pain on taking the first steps in the morning after waking from sleep
  • Tenderness in the heel area
  • Difficulty bringing your toes towards your shin
  • Pain when climbing stairs or walking on hard surfaces
  • High BMI 
  • Sedentary lifestyle
  • Long hours of standing particularly on hard flooring

How Do We Treat It?

In the short-term
  • Minimise the aggravating activity. For example, avoid running until your heel has been pain-free for 4 weeks and you can walk 10km without pain during the walk of morning after 
  • If you need to war dress shoes, consider using soft silicone gel heel pads or contoured pre-fabricated foot orthoses in your shoes
  • It is important that you decrease or avoid activities that cause your heel pain to worsen 
  • When you want to star activities again, you should be careful and progress slowly 
Medium term 
  • Customised foot orthoses 
  • Corticosteroid injection 
  • High load strength training 
Long term 

Conservative 

  • Taping, customised and prefabricated foot orthoese 
  • Heel pads 
  • Night splints 
  • Stretching exercises 

Non-conservative 

  • Corticosteroid injection 
  • Extracroporeal shock wave therapy 
  • Surgery 

What Happens if It Goes Untreated? 

If left untreated, plantar fasciopathy can cause pain for a very long time (most cases last at least six months), and, because the pain can cause you to change the way you walk, there is a risk of further, potentially more serious damage being caused. So, it’s best to see a physiotherapist as soon as possible.

Some form of rest or alteration to your normal routine is important, particularly for plantar fasciopathy, and we’re likely to tell you to take a temporary break from running or other sports that may lead to continued excessive load being placed on the tissues, and ultimately, delayed healing.

We can perform soft tissue releases of the arch of the foot and other areas of the body including anywhere from the low back to the foot, to help relieve the pain and restore some movement. There are stretches and strengthening exercises that we can work with you on to help rehabilitate the plantar fascia and any other underlying causes. We may also recommend shoe inserts, orthotics or night splints to support the area while it recovers.

In the vast majority of cases, treatment and time will be enough to combat the issue. We will always aim to follow a conservative approach before making use of more invasive techniques.

Take Home Message 

The pain related to plantar fasciopathy is usually of gradual onset and felt classically on the inferior medial aspect of the heel. Initially, it is worse in the morning when getting out of bed and decreases with activity, only to return with an ache post-activity.

Periods of inactivity during the day are generally followed by an increase in pain as activity is recommended. As the condition becomes more severe, the pain may be present when standing and worse with activity.

Some people may also experience pain when non weight bearing for example when going to bed at night. If this sounds like you, reach out to Precision Physio to help get you back on the right track and onto recovery

Want To Know More?

We’d suggest contacting our team at Precision Physio, so that we can help you with your individual case.

How Do I Book An Appointment?

We’re taking the health of our clients, members and staff very seriously and our preference would be for you to call to book an appointment so that we can make sure to explain our approach to keeping you safe. You can call any of these numbers to schedule a session:

Online Consultations

Evolving with the current environment, we are also now offering online appointments, meaning that we can support anyone who is unable to leave their home. Sessions are done via our state of the art Telehealth system and as long as you have a laptop or tablet with an inbuilt camera, or a phone with camera, we can help!

To learn more about online consultations, please call us on any of the numbers listed above.

Jon Perkins

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