Plantar fasciitis is a condition that produces significant pain for prolonged periods in individuals. Plantar fasciitis can be of an acute onset but typically it is chronic in nature. Plantar fasciitis tends to bother people for long periods of time, and patients often don’t seek treatment until it has been bothering them for a significant amount of time and the injury has become chronic.
Symptoms
Plantar fascial pain most often localizes to the heel but can be present in the arch of the foot as well. Pain tends to be worst in the morning, eases as the day progresses and tissue loosens up, and increases at the end of the day because of the volume of the activity. Weight-bearing activity often increases pain, as do periods of inactivity. Clients typically feel better in supportive shoes than bare foot. Anti-inflammatories and pain-relievers may or may not be effective depending on the amount of swelling and inflammation.
Treatment
ASTYM – ASTYM is a manual physical therapy technique designed to stimulate healing in chronically unhealthy tissue. It is a deep tissue technique facilitated with a set of plastic instruments applying pressure over the skin in parallel with healthy tissue. ASTYM is designed to treat tissue in which the healing process has burned itself out and stagnated. Please see our previous post on the ASTYM technique.
Home Exercise – In conjunction with ASTYM, it is important to remain active and introduce strain to the tissue in a controlled way. This often means maintaining or increasing current activity levels as you tolerate. In addition to maintaining activity, patients should performing stretching exercises for both the plantar fascia and the calf/Achilles. Another great technique for improving flexibility and mobility is using a tennis ball to provide deep pressure through the plantar fascia. Immediately following the tennis ball mobilization, stretch through the plantar fascia as mentioned previously. Strengthening of the muscles within the foot is also important. Improving the strength and endurance of the intrinsic muscles removes stress from the plantar fascia. See the post from December 2, 2014 to explore some of these exercises. Strengthening of the hip musculature is also important in foot health. Strong gluteals and hips allow lower leg alignment to be maintained.
Other Treatment
Orthotics are not my first choice of treatment of plantar fasciitis, but they can work well in certain cases. Other treatment may include stretching and flexibility training of the knees and hips, balance and stability training, or cross training. It is very important not to address the foot in isolation. Oftentimes, the cause of plantar fasciitis is multi-factorial, and treating just the foot will set you up for pain down the road.
If you have been having chronic foot pain, contact us at Stadia Sports Medicine, relief is in reach.