What is plantar fasciitis?
Plantar fasciitis is a condition in which there is injury and inflammation in the plantar fascia, i.e. the part of the connective tissue that forms the arch of the sole.
This usually happens at the point where the plantar fascia joins the heel bone. Plantar fasciitis is the most common cause of pain in the heel area.
During walking or running tension is created in the plantar fascia. When this tendency is excessive or repetitive, the plantar fascia is injured. This condition is also characterized by inflammation and degeneration of the area.
This can be exerted by a very large load along the plantar fascia (greater than its strength) or by its gradual injury due to overuse.
Sometimes the so-called “heel spur” develops due to plantar fasciitis.
Cause of plantar fasciitis
It usually occurs in runners, dancers and instrumental athletes. Also in people who walk too much especially on uphill ground or uneven surfaces. It also occurs in older patients who stand for long periods of time.
Plantar fasciitis is often associated with stiffness of the gastrocnemius muscles or with incorrect biomechanical limb flexion such as flatfoot or clubfoot.
Patients with plantar fasciitis experience pain below the heel and along the sole. There is a hypersensitive spot when touching the lower surface of the heel. The pain is increasing in the first steps of the day and subsides as the area warms up.
In mild cases patients ache after walking, running, jumping, etc. As the disease progresses, pain also exists during the above activities.
In very severe cases the patient is unable to charge his leg.
A history and clinical examination are sufficient to lead the physiotherapist to diagnose plantar fasciitis. Additional tests (x-rays, diagnostic ultrasound, magnetic topography) confirm the injury and determine the exact degree of fracture.
The treatment of plantar fasciitis requires a detailed evaluation of all the factors that cause it, as well as their effective treatment. Most patients recover completely with appropriate physiotherapy. The degree of success of the treatment depends to a large extent on the cooperation of the patient with the physiotherapist. It is very important to avoid activities that increase the symptoms. This helps the body heal its damaged tissues.
Avoid activities such as running, standing and jumping. Ignoring the pain and symptoms and continuing the full activity the condition passes into the chronic stage. Immediate and appropriate treatment is valuable for the rapid recovery and healing of the injury. The treatment for the first 72 hours aims to reduce pain and swelling, so the patient rests the leg and applies ice therapy (3 to 4 times a day).
Causes of plantar fasciitis
There are many factors that cause plantar fasciitis. All should be evaluated by a physiotherapist and treated appropriately. Some of them are:
- Biomechanical imbalance (especially flatfoot)
- Ankle joint stiffness
- Calf muscle stiffness (gastrocnemius, tibia)
- Excessive training is inappropriate
- Overweight patients
- Unsuitable shoes
- Insufficient warm-up
Physiotherapy for plantar fasciitis
Physiotherapy in patients with plantar fasciitis is necessary for the rapid and complete recovery of the disease.
- Manual therapy
- Exercises to improve elasticity, strength and balance
- Dry needle technique
- Ergonomics tips
- Program for gradual return to daily activities