Plantar fasciitis affects nearly 2 million Americans each year, with over 10% of the population suffering from this condition at some point over their lifetime. This painful condition is generally thought to be an overuse condition tending to occur more often in women, military recruits, older athletes, young male athletes or those with an elevated body mass index (BMI). The plantar fascia functions during walking to help support the arch of the foot and act as a shock absorber as the foot meets the ground. Overtime, many microtrauma may lead to degeneration of the plantar fascia, causing heel pain or what is commonly referred to as “plantar fasciitis”.
Symptoms:
The most common symptoms of plantar fasciitis include pain at the heel, especially with the first step out of bed in the morning, or after a period of prolonged sitting. Some people also complain of pain in the mid portion of the arch of the foot. Depending on the stage of irritation, the symptoms may get better with walking or movement.
Causes:
Plantar fasciitis is generally considered an overuse injury. It can be caused by many factors including improper shoe wear, weak muscles that support the arch or biomechanical dysfunction of the foot and ankle. It is important to determine the cause of your individual plantar fasciitis in order to fully resolve the symptoms. Without identifying the root cause of the irritation, symptoms will likely persist or reoccur.
Treatment:
REST
It is important to allow the plantar fascia to rest. This may mean avoiding running, prolonged walking, or using an orthotic or other arch support in your shoe to let the necessary healing take place. Speak with your healthcare provider to determine appropriate activity modifications for your lifestyle.
CALF STRETCHES
The calf muscles attach to the top of the heel bone. If they are tight, it may cause extra stress on the plantar fascia which attaches to the bottom of the heel bone. Sometimes heel pain resolves with a diligent stretching program that includes stretching the calf three times for at least 30 seconds each, performed 3 times per day. For optimal results, perform calf stretches with the knee straight and with the knee bent to stretch both parts of the calf muscle.
TOWEL SCRUNCHES
Sit in a chair with a washcloth on the floor in front of you. The best surface is a tile or hardwood floor. Keeping your heel on the ground, use your toes to "scrunch" the towel back toward your heel.
ICE BOTTLE MASSAGE TO PLANTAR FASCIA
Fill a water or sports drink bottle (preferably a bottle that has some grooves) approximately ¾ full. Place in freezer. After the liquid has frozen, you can use the bottle to provide an ice massage to the bottom of your foot. Gently roll your foot over the frozen bottle for 5-7 minutes once per day. Using the water bottle allows for easy clean up and recycled use; simply re-freeze the bottle for continued use.
SELF MASSAGE TO PLANTAR FASCIA
While sitting in a chair, cross the affected foot over the opposite knee. Extend the toes on the affected foot back toward the shin using one hand, while using the other hand to gently massage the arch of the affected foot. Massage the arch for 2-5 minutes, focusing on areas of increased pain or tightness.
If your heel pain does not resolve with these simple exercises, it is important to seek advanced medical advice from your physician or physical therapist.
Andrea Johnson, PT, DPT, ATC is a physical therapist at the OrthoCarolina Huntersville office. She received her BS in Athletic Training from Otterbein College and her Doctor of Physical Therapy from Ohio University.
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