Monday, 2 November 2015

Plantar Fasciitis

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

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