plantar fasciitis

see also:

• the painful foot
• patient information:
  • https://physioworks.com.au/injuries-conditions-1/plantar-fasciitis
  • https://www.racgp.org.au/clinical-resources/clinical-guidelines/handbook-of-non-drug-interventions-(handi)/other/stretching-exercises-for-plantar-fasciitis

• one of the most common causes of foot pain and it is often bilateral
• it is usually caused either by:
  • repeatedly overstretched
  • blunt trauma such as landing on an object causing bruising to the sole of the foot

• pain under the heel or foot arch often present on waking and worse with initial walking but often improves with activity as it warms up

• stage 1 - no pain, normal
• stage 2 - pain after exercise
• stage 3 - pain before and after exercise
• stage 4 - pain before, during and after exercise
• stage 5 - pain at all times even during rest

• over-use activities especially if new activity, have tight calf muscles, ankle injury limitation or poor shoes:
  • hiking, running, aerobics, ballet
  • excessive walking on hard surfaces eg. factory workers, police, teachers and waitresses
• obesity
• pregnancy - loss of ligament supports
• poor biomechanics and foot issues - flat feet or high arch
• age - middle age or elderly tend to lose arch in foot
• shoes with poor supports
• weak foot arch muscles
• diabetes

• consider foot XR to exclude stress fracture metatarsals if tenderness is in mid foot rather than heel area
• 90% will resolve within 2 months of Rx
  • rest, ice, analgesics, non-steroidal anti-inflammatory drugs (NSAIDs)
  • consider plantar fascia brace, heel cups
  • physiotherapy options
    • joint mobilisations to loosen stiff joints
    • soft tissue massage or release
    • muscle flexibility or stretches
    • foot taping
    • active foot stabilisation exercises
    • lower limb strengthening exercises
  • orthotics