What is the plantar fascia?
The plantar fascia is a thick band of connective tissue which connects the heel to the ball of the foot. Its primary function is to support the medial longitudinal arch of the foot in weight bearing. It achieves this via the Windlass mechanism.
The Windlass Mechanism occurs when weight is transferred onto our toes, resulting in tightening of the plantar fascia. This in turn raises the height of the arch and in doing so stabilises the bones of the foot.
What is plantar fasciitis or fasciopathy?
It is an umbrella term for conditions effecting the plantar aspect (sole) of the foot (e.g. plantar fasciitis, calcaneal heel spurs). It most often presents as a gradual, insidious onset of pain localised to the heel of the foot but can also present in the middle of the sole. Individuals with this condition complain of pain upon initial weight bearing after rest, pain at the beginning of a run and pain with barefoot or minimalist footwear (e.g. thongs).
It can affect those of all ages, particularly young, highly active, and older, sedentary individuals.
Risk factors for plantar fasciopathy
– Obesity (High BMI)
– Over pronated/flat feet
– Excessive weight bearing/activity (e.g. running, walking, standing)
– Poor footwear
How can we treat heel pain?
There are several ways to reduce heel pain in the short term and they include activity modification, changing foot mechanics (via taping, footwear, orthotics), icing, stretches and medication (e.g. NSAIDs).
After assessing your unique impairments and presentation, a physiotherapist will be able to guide you in terms of the ideal initial treatment to ease your heel pain. Once pain is decreased, a physiotherapist will be able to work with you to gradually return to your meaningful activities whether that is standing to cook dinner or if is to run 5km around the block. Depending upon the chronicity (i.e. duration of symptoms), a physiotherapist may recommend foot and ankle strengthening. For those with chronic plantar heel pain, it may be worthwhile to begin a targeted strengthening program to improve the capacity of your plantar fascia to withstand the large forces being transferred through it.
Are you in Adelaide and experiencing heel pain? Get in touch with us at 1300 189 289 to schedule an appointment with one of our many physiotherapists.
References:
Latt, L.D. et al. (2020) “Evaluation and treatment of chronic plantar fasciitis,” Foot & Ankle Orthopaedics, 5(1), p. 247301141989676. Available at: https://doi.org/10.1177/2473011419896763.
Plantar fasciitis: Foot and heel pain (no date) Parkway East. Available at: https://www.parkwayeast.com.sg/specialties/medical-specialties/bones/foot-pain (Accessed: January 11, 2023).
Whitney, K.A. (2022) Plantar fasciosis – bone, joint, and Muscle Disorders, MSD Manual Consumer Version. MSD Manuals. Available at: https://www.msdmanuals.com/home/bone,-joint,-and-muscle-disorders/foot-problems/plantar-fasciosis (Accessed: January 11, 2023).
Windlass Test (no date) Physiopedia. Available at: https://www.physio-pedia.com/Windlass_Test (Accessed: January 11, 2023).
