Plantar Fasciitis….

Best Practice Management for Plantar Fasciitis: A Physiotherapy Perspective

Plantar fasciitis (or plantar fasciopathy) is one of the most common causes of heel pain, affecting individuals across various activity levels and age groups. At PhysioHub, we understand the challenges this condition can pose, from sharp morning heel pain, to difficulty in daily activities. Or if youre a runner struggling to keep up with your usual mileage. Here, we outline the best practices for managing plantar fasciitis effectively through physiotherapy.

Understanding Plantar Fasciitis

Plantar fasciitis or plantar fasciopathy is an irritation of the fibrous tissue (plantar fascia) along the bottom of your foot that connects your heel bone to your toes. Common causes are thought to include:

·       - Overuse, especially in runners or individuals standing for long hours.

·       -  Low arches/flat feet or high arches.

·       - Tight calf muscles or Achilles tendons.

·       - Sudden increases in activity or weight.

·       -Weakness in certain muscle groups in and around foot, knee, hip.

Symptoms typically include stabbing heel pain, often worse in the morning or after prolonged rest.

Physiotherapy: The Key to Effective Management

Physiotherapy offers evidence-based, non-invasive strategies for treating plantar fasciitis. Here’s a comprehensive guide to best practice management:

Physiotherapy assessment of plantar fasciitis.

Assessment and Diagnosis

Before starting treatment, a thorough assessment is crucial. A physiotherapist will evaluate your:

-Training schedule.
- Gait and foot mechanics.
- Muscle flexibility and strength, especially in the calf and foot muscles.
- Triggering activities and contributing factors, like footwear or weight distribution.

Stretching and Mobility Exercises

-Tightness in the calf muscles and plantar fascia can exacerbate symptoms. A tailored stretching program can relieve tension and improve flexibility. Key exercises include:
- Calf Stretch: Keep your heel on the ground and lean forward to stretch the back of your leg.
- Plantar Fascia Stretch: Use a towel or stretch band under your toes, pulling gently to stretch the sole of your foot.

Strengthening Exercises

Building strength in the foot and lower leg muscles helps improve support and reduce strain on the plantar fascia. A study by Abdelnaeem et al (2023) found runners with plantar fasciitis had significant weakness in their hip abductor muscles. Following assessment, a tailored strengthening program will be designed for you.

Manual Therapy

Hands-on techniques, such as soft tissue mobilization or trigger point therapy, can help reduce pain and improve circulation to promote healing.

Orthotics and Footwear Advice

Proper footwear plays a critical role in managing plantar fasciitis. A physiotherapist may recommend:

-A full biomechanical assessment. At Physiohubs stockport clinic, our in-house Biomechanics expert Brenda offers full Biomechanical assessment with custom made orthoses. Click here to learn more about this service
- Shoes with adequate arch support and cushioning.

Modalities for Pain Relief

Physiotherapy treatments to reduce pain and inflammation include:
- Ice Therapy: Apply an ice pack or roll your foot over a frozen bottle for relief.
- Taping Techniques: Application of tape can offload stress from the plantar fascia. A recent review by Morrissey et al (2021) concluded that low dye taping combined with stretching the plantar fascia is the most effective management of plantar fascia.

Gradual Return to Activity

A stepwise approach to resuming activities like running or prolonged standing ensures the plantar fascia heals properly. Your physiotherapist can guide you through this process while addressing contributing factors. For runners, a specific return to running program will be discussed or strategies to build your mileage slowly.

Return to running 

Preventing Recurrence

Preventative strategies are essential for long-term management:
- Maintain flexibility and strength: Regular stretching and strengthening exercises.
- Wear supportive footwear: Avoid walking barefoot on hard surfaces.
- Monitor activity levels: Gradual progression in sports or exercise routines.

When to Seek Help

If your heel pain persists despite self-management or starts to interfere with your daily life, seeking professional care is essential. Early intervention leads to faster recovery and prevents chronic issues.

At PhysioHub, our personalized treatment plans are designed to address your unique needs, ensuring a quicker return to pain-free movement. If you’re struggling with plantar fasciitis, contact us today to begin your journey toward recovery!

*Ready to take the first step toward relief? Schedule an appointment with PhysioHub now!*