Plantar Fasciitis

What is Plantar Fasciitis?

Plantar fasciitis is a common condition that causes pain in the bottom of your foot, particularly near the heel. It occurs when the plantar fascia, a thick band of tissue that runs across the bottom of your foot connecting your heel bone to your toes, becomes inflamed or irritated.

At Tangram Health, our team of Physiotherapists and Chiropractors in Sydney often see patients with plantar fasciitis. We understand how this condition can affect your daily activities and quality of life, and we're here to help you find relief and improve your foot health.

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What are the symptoms of Plantar Fasciitis?

The main symptom of plantar fasciitis is pain in the bottom of your foot, typically near the heel. Other symptoms may include:

• Sharp, stabbing pain that's usually worse in the morning when you take your first steps
• Pain that increases after standing for long periods or when you get up after sitting
• Pain that's triggered by climbing stairs or after intense activity
• Heel pain that increases over a period of months
• Swelling or redness in the heel area
• Tight calf muscles
• Difficulty flexing your foot or pointing your toes

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What causes Plantar Fasciitis?

Plantar fasciitis is typically caused by repetitive strain on the plantar fascia. This can happen due to various reasons:

• Excessive running or walking, especially on hard surfaces
• Sudden increase in physical activity
• Prolonged standing, especially on hard surfaces
• Wearing shoes with poor arch support or soft soles
• Foot structure problems like high arches or flat feet
• Tight calf muscles that limit ankle flexibility
• Being overweight, which puts extra stress on your feet
• Age-related loss of cushioning in the heel

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How is Plantar Fasciitis diagnosed?

When you visit one of the Tangram Health clinics with symptoms of plantar fasciitis, our Physios and Chiros will use several methods to diagnose your condition:

• Medical history: They'll ask about your symptoms, when they started, and how they affect your daily life.
• Physical examination: Your Physiotherapist or Chiropractor will:
  • Check for areas of tenderness in your foot
  • Assess the flexibility of your ankle
  • Evaluate your foot posture and gait (how you walk)
  • Test your muscle strength and the health of your nerves
• Imaging tests: In some cases, X-rays, Ultrasounds, and MRI scans may be recommended to rule out other causes of heel pain.

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What other conditions can mimic Plantar Fasciitis?

Several conditions can cause symptoms similar to plantar fasciitis:

• Heel spurs: Bony growths on the heel bone
• Tarsal tunnel syndrome: Compression of a nerve in the ankle
• Stress fractures in the heel bone
• Achilles tendinitis: Inflammation of the Achilles tendon
• Fat pad atrophy: Thinning of the fat pad under the heel
• Nerve entrapment: Pinched nerves in the foot or ankle

It's important to get an accurate diagnosis to ensure proper treatment. At Tangram Health, our Physiotherapists and Chiropractors are all skilled in differentiating between these conditions and can provide you with a sensible treatment plan based on your specific condition.

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Do I need scans to see if I have Plantar Fasciitis?

While plantar fasciitis is often diagnosed through physical examination, imaging tests can be helpful in some cases:

• X-rays: These can show heel spurs, but aren't typically used to diagnose plantar fasciitis itself.
• Ultrasound: This can show the thickness of the plantar fascia and whether it's inflamed.
• MRI (Magnetic Resonance Imaging): This might be used if the diagnosis is unclear or to rule out other causes of heel pain.

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How is Plantar Fasciitis treated?

Treatment for plantar fasciitis aims to reduce pain and inflammation, improve flexibility, and promote healing of the plantar fascia. At Blacktown Health, we offer a range of treatments, including:

• Rest and ice: To reduce pain and inflammation
• Stretching exercises: Our Blacktown physio team can teach you specific stretches for your plantar fascia and calf muscles
• Orthotics: Custom-made or over-the-counter shoe inserts to support your arch
• Night splints: To keep the plantar fascia stretched while you sleep
• Taping: To support the bottom of your foot
• Proper footwear: Recommendations for shoes with good arch support and cushioning
• Physical therapy: Including manual therapy and exercises
• Shockwave therapy: To stimulate healing in the plantar fascia
• Injections: In some cases, corticosteroid injections might be used
• Surgery: In severe cases that don't respond to other treatments

Our Physiotherapists and Chiropractors in Sydney can work with you to create a treatment plan involving these treatments, depending on your specific needs, goals, and what you've tried before.

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How do orthotics help with Plantar Fasciitis?

Orthotics are shoe inserts that can help with plantar fasciitis by:

• Providing arch support to distribute pressure more evenly across your foot
• Cushioning your heel to reduce impact when walking or running
• Correcting foot posture issues that might be contributing to your plantar fasciitis

At Tangram Health, we can assess whether orthotics might be beneficial for you and provide advice on choosing the right type.

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What are night splints and how do they help?

Night splints are devices worn while you sleep that keep your foot in a flexed position, gently stretching your plantar fascia and calf muscles. They can help by:

• Preventing the plantar fascia from tightening overnight
• Reducing morning pain and stiffness
• Promoting healing by maintaining a gentle stretch

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How does taping help with Plantar Fasciitis?

Taping involves applying athletic tape to the bottom of your foot to support the plantar fascia. It can help by:

• Providing immediate pain relief
• Supporting the arch of your foot
• Reducing stress on the plantar fascia during activities

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What stretches are helpful for Plantar Fasciitis?

Stretching is a crucial part of treating plantar fasciitis. Some helpful stretches include:

• Plantar fascia stretch: Rolling your foot over a cold water bottle or tennis ball
• Calf stretch: Leaning against a wall with one leg behind you
• Towel stretch: Pulling your toes towards you with a towel while seated

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When are injections used for Plantar Fasciitis?

Injections, typically corticosteroids, are sometimes used to treat plantar fasciitis when other conservative treatments haven't provided enough relief. They can help by:

• Reducing inflammation in the plantar fascia
• Providing significant short-term pain relief

However, injections are usually limited to a few times a year, as repeated injections can weaken the plantar fascia. At Tangram Health, our healthcare professionals can discuss whether injections might be appropriate for your condition.

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What is shockwave therapy and how does it help Plantar Fasciitis?

Shockwave therapy, also known as Extracorporeal Shock Wave Therapy (ESWT), is a non-invasive treatment that uses pressure waves to stimulate healing in the plantar fascia. It can help by:

• Increasing blood flow to the area
• Stimulating the production of collagen, which is important for tissue repair
• Breaking down scar tissue
• Reducing pain

At Tangram Health, we offer shockwave therapy as a treatment option for plantar fasciitis. Our Physios and Chiros can assess whether this treatment might be suitable for you.

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When is surgery required for Plantar Fasciitis?

Surgery for plantar fasciitis is generally only considered when:

• Conservative treatments haven't improved your symptoms after 6-12 months
• Your pain is severe and significantly affects your quality of life

Surgical options may include:

• Plantar fascia release: Partially cutting the plantar fascia to relieve tension
• Gastrocnemius recession: Lengthening the calf muscles to reduce stress on the plantar fascia

If surgery is being considered, our Physiotherapists and Chiropractors can help recommend good orthopaedic and podiatric surgeons to help, as well as guiding you through the rehabilitation journey after surgery.

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What role does exercise play in treating Plantar Fasciitis?

Exercise is a crucial part of treating and preventing plantar fasciitis. It helps to:

• Strengthen the muscles in your feet and lower legs
• Improve flexibility in your plantar fascia and calf muscles
• Enhance your foot's ability to handle stress
• Promote proper movement patterns

Our Physiotherapists, Chiropractors, and Exercise Physiologists at Tangram Health can design an exercise program tailored to your specific needs. This might include:

• Toe curls and toe spreads to strengthen foot muscles
• Calf raises to strengthen lower leg muscles
• Balance exercises to improve foot and ankle stability
• Low-impact aerobic exercises like swimming or cycling to maintain fitness without stressing your feet
  

Remember, it's important to start gently and gradually increase the intensity of your exercises.

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How can I prevent Plantar Fasciitis or stop it from getting worse?

While you can't prevent all cases of plantar fasciitis, there are steps you can take to reduce your risk or prevent it from worsening:

• Maintain a healthy weight to reduce stress on your feet
• Wear supportive shoes with good arch support and cushioning
• Replace your shoes regularly, especially if you're a runner
• Stretch your calves and feet regularly
• Gradually increase the intensity of your exercise routine
• Avoid going barefoot on hard surfaces
• Use proper technique during activities to avoid unnecessary stress on your feet
• Rest and ice your feet after intense activity or long periods of standing

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When should I see a healthcare professional about foot pain?

You should consider seeing a healthcare professional if:

• You have persistent pain in your foot, especially in the heel area
• Your pain is affecting your daily activities or sleep
• You're having difficulty walking normally
• You've tried home remedies without success
• You have diabetes and are experiencing foot pain (as diabetics are at higher risk for foot problems)

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Take home message

Plantar fasciitis can be a painful condition that can significantly impact your ability to walk and enjoy life. However, with proper diagnosis, treatment, and rehabilitation, most people with plantar fasciitis can return to their normal activities and even high-level sports.

At Tangram Health, our team of experienced Physiotherapists, Chiropractors, and Exercise Physiologists in Sydney can help you manage your plantar fasciitis effectively. We offer a range of treatments and can provide personalised advice on exercises, taping, orthotics, shockwave, and strategies for preventing ongoing issues. Remember, early intervention is key in overcoming plantar fasciitis.

If you're experiencing heel pain from plantar fasciitis, don't hesitate to us at Tangram Health. We also have clinics conveniently located around Sydney in Mt Kuring-Gai, Asquith, Willoughby, Milsons Point, Dural, and Blacktown, so you can get the right advice and treatment for your plantar fasciitis.