Have you got pain in your foot? You could have plantar fasciitis, plantar fascia pain or plantar fasciopathy. What do all those things actually mean? And why just stretching is not going to help your plantar fascia pain go away?
What is the plantar fascia?
The plantar fascia is a soft tissue structure most similar to tendons. It runs from the under part of your heel bone (calcaneum) and then fans out to attach to the base of each of your toes. It comes under load when we are on our feet and helps us to walk normally. Unfortunately it can sometimes cause pain and there are various terms to describe the different states of the tissue.
This, in it’s truest sense, is an acute (less than 6 weeks) inflammatory reaction of the tissue in response to being suddenly overloaded – lots of walking, jumping, running, being on your feet beyond what you’d normally do. If this is what you have got, back off from being on your feet as much, rest up for a couple of days or weeks, and then as your pain settles gradually get going again. Job done!
Now most people unfortunately don’t have this presentation, they just describe a gradual onset of symptoms over time. This is typically not inflammatory therefore not an ‘itis’ (meaning ‘inflammation of’).
It sounds terrible but plantar fasciopathy is a term to describe the tissue when it is in a degenerative state. It is similar in it’s features to how long standing tendon problems present, where changes in the tissue called collagen (the stuff it’s made up of) can happen where it breaks down, can calcify and nerve or blood supply can grow in. Degenerative categorically does not mean it will snap or that all hope is lost, it just means that the tissue is not in great shape. But the wonderful thing about our bodies is we can change and adapt!
There are often 2 phases to plantar fasciopathy:
Pain dominant phase
Painful and stiff first thing in the morning, painful on start up from sitting, walking longer distances or standing too long. The aim in this phase is to reduce the load, so get off your feet in a similar way to a true plantar faci ‘itis’.
Load dominant phase
Basically overall it’s better (less painful) unless you overdo it. So what now? Simple, load it. Gradually and progressively get the tissue stronger to make it more resilient and tough.
Some people may benefit from losing weight if it’s indicated, often you may be tight in your calves, but stretching alone will not resolve the problem.
Sometimes people are stiff into toe extension although the jury is out in terms of the research on this one. Ultimately if it’s tight stretch it, it will do no harm.
There has been found to be some association with reduced toe flexor and evertor muscle strength, and tight hamstrings. Again it will cause you no harm to get stronger in your foot and looser in your hamstrings. Often footwear with a hard insole can make things painful so if it helps a soft insole or trainers can help.
Runners are a group that sometimes get this problem. It can be due to an increased pace, or alteration in your footwear or strike pattern. Initially follow the general advice above.
If you think you might have this and are not sure what your contributing factors are and how to get the plantar fascia stronger, please get in touch on 01625 422825 and start on the road to recovery!
You can get rid of all this pain in a fairly short space of time, you just need some good rehab specific to you. We treat the person with the problem not just the problematic body part. We want to help you enjoy your life, pain free!