What to look for and causes?
The injury is usually near to where the plantar fascia attaches to your heel bone. You are more likely to injure your plantar fascia in certain situations.
* Being on your feet for a lot of time, or if you do lots of walking, running, standing, etc, when you are not used to it. If you have recently started exercising on a different surface for example, running on the road instead of a track.
* Wearing shoes with poor cushioning or poor arch support.
* If you are overweight – this will put extra strain on your heel.
* Overuse or sudden stretching of your sole. e.g. athletes who increase running intensity or distance.
* If you have a tight Achilles tendon. This can affect your ability to flex your ankle and make you more likely to damage your plantar fascia.
Pain is the main symptom. This can be anywhere on the underside of your heel. However, commonly, one spot is found as the main source of pain. This is often about 4 cm forward from your heel, and may be tender to touch.
The pain is often worst when you take your first steps on getting up in the morning, or after long periods of rest where no weight is placed on your foot. Gentle exercise may ease things a little as the day goes by, but a long walk or being on your feet for a long time often makes the pain worse. Resting your foot usually eases the pain.
What should I do?
Usually, the pain will ease in time. Fascia tissue, like ligament tissue, heals quite slowly. It may take several months or more to go. However, the following tips may help to speed recovery.
Rest your foot
This should be done as much as possible. Avoid running, excess walking or standing, and undue stretching of your sole. Gentle walking is fine.
Do not walk barefoot on hard surfaces. Choose shoes with cushioned heels and a good arch support. A laced sports shoe rather than an open sandal is probably best. Avoid old or worn shoes that may not give a good cushion to your heel’s and avoid wearing Flip Flops!!!
Heel pads and arch supports
You can buy various pads and shoe inserts to cushion the heel and support the arch of your foot. These work best if you put them in your shoes at all times. The aim is to raise your heel by about 1 cm. If your heel is tender, cut a small hole in the heel pad at the site of the tender spot. This means that the tender part of your heel will not touch anything inside your shoe. Place the inserts/pads in both shoes, even if you only have pain in one foot.
Painkillers such as paracetamol will often ease the pain. Sometimes anti-inflammatory medicines such as ibuprofen are useful. These are painkillers but also reduce inflammation and may work better than ordinary painkillers. Some people find that rubbing a cream or gel that contains an anti-inflammatory medicine on to their heel is helpful.
An ice pack held to your foot for 15-20 minutes may also help to relieve pain.
Regular, gentle stretching of your Achilles tendon and plantar fascia may help to ease your symptoms. This is because most people with plantar fasciitis have a slight tightness of their Achilles tendon. If this is the case, it tends to pull at the back of your heel and has a knock-on effect of keeping your plantar fascia tight. Also, when you are asleep overnight, your plantar fascia tends to tighten up (which is why it is usually most painful first thing in the morning). The aim of these exercises is to loosen up the tendons and fascia gently above and below your heel. Your doctor may refer you to a physiotherapist for exercise guidance.
The following exercises, done either with or without shoes on, can be used to help treat plantar fasciitis:
* Stand about 40 cm away from a wall and put both hands on the wall at shoulder height, feet slightly apart, with one foot in front of the other. Bend your front knee but keep your back knee straight and lean in towards the wall to stretch. You should feel your calf muscle tighten. Keep this position for several seconds, then relax. Do this about 10 times then switch to the other leg. Now repeat the same exercise for both legs but this time, bring your back foot forward slightly so that your back knee is also slightly bent. Lean against the wall as before, keep the position, relax and then repeat 10 times before switching to the other leg. Repeat this routine twice a day.
* Stand on the bottom step of some stairs with your legs slightly apart and with your heels just off the end of the step. Hold the stair rails for support. Lower your heels, keeping your knees straight. Again you should feel the stretch in your calves. Keep the position for 20-60 seconds, then relax. Repeat six times. Try to do this exercise twice a day.
* Sit on the floor with your legs out in front of you. Loop a towel around the ball of one of your feet. With your knee straight, pull your toes towards your nose. Hold the position for 30 seconds and repeat three times. Repeat the same exercise for the other foot. Try to do this once a day.
* For this exercise you need an object such as a rolling pin or a drinks can. Whilst sitting in a chair, put the object under the arch of your foot. Roll the arch of your foot over the object in different directions. Perform this exercise for a few minutes for each foot at least twice a day. This exercise is best done without shoes on.
Can plantar fasciitis be prevented?
There are certain things that you can do to try to prevent plantar fasciitis, especially if you have had it before. These include:
Regularly changing training shoes used for running or walking.
Wearing shoes with good cushioning in the heels and good arch support.
Losing weight if you are overweight.
Regularly stretching the plantar fascia and Achilles tendon, especially before exercise.
Avoiding exercising on hard surfaces. Run or walk on a sprung Treadmill instead of the road while recovering.
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