Plantar fasciitis is one of the most common foot injuries,
affecting approximately 10% of runners. It is an inflammatory condition, in
which the connective tissue on the underside of the foot becomes inflamed. Intrinsic
factors contributing to this condition include biomechanical factors related to
the foot and ankles, as well as muscle imbalances in strength and flexibility
of the lower leg and foot muscles. Extrinsic factors include incorrect
footwear, poor training and excessive running on hard or uneven surfaces.
Signs and Symptoms
Pain is experienced on the underside of the foot, near the
heel, and is usually worse after rest and will be particularly severe first
thing in the morning when weight is placed on the foot. This pain tends to improve
within a few minutes of walking. In more severe cases, where there is neural
involvement as well, pain is more severe and widespread. Pain often improves
with activity, but will recur after rest.
Management
Ice and non-steroidal anti-inflammatory drugs are used to
manage the acute pain and inflammation. Massage is used to reduce inflammation
in the fascia. Strapping and heel lifts may be used to take the pressure off
the arch of the foot. Achilles tendon stretches should be performed, as well as
various other exercises to improve range of motion in the ankle and foot,
within pain-free ranges. Gentle strengthening exercises can be done to improve
muscle strength around the foot and ankle, again within pain-free ranges. A
biokineticist can then assess factors contributing to the condition and provide
appropriate stretching and strengthening exercises to improve muscle
imbalances, thereby preventing the condition form recurring.
References
Foundations of Athletic Training: Prevention, Assessment and
Management
