Explained: plantar fasciitis

We look at the causes, symptoms and cure for this common runner’s injury, which starts out as pain around the heel and can quickly lead to an acute tear or rupture if ignored

Published: August 28, 2014 at 2:11 pm

Plantar fasciitis is the medical term for the thickening and alteration in the structure of the plantar fascia.

The plantar is a thick band of flexible but tough tissue that runs under the sole of the foot, connecting the heel bone to the smaller bone of the foot.

The plantar fascia has two main functions: during walking in the ‘heel raise to toe-off’ phase, the plantar fascia assists in stabilising the arch of the foot; and it also acts as a shock absorber when the foot hits and makes contact with the ground.

Symptoms

The main symptom of plantar fasciitis is pain around the heel that you can feel when standing, walking and running. This is often worse first thing in the morning. Inflammation or injury of the plantar fascia can occur suddenly with an acute tear or rupture, or can happen over several months where small micro-tears develop in the structure, causing thickening and a decrease in its ability to absorb and transfer load.

Causes

- Poor lower limb and foot biomechanics
- Poor lower limb and foot strength and conditioning
- A change or alteration in footwear, wearing ill-fitting or the wrong type of shoe for your foot
- Changes in training, such as increased volume or speed work, or running when fatigued
- Changes in running terrain
- Tightness in the calf and Achilles complex

Prevention and cure

Each person will have a specific combination of factors leading to plantar fasciitis. The most important thing is to have the condition properly diagnosed and treated. Part of this will involve the therapist assessing your foot and function of your lower limb to look at what factors need alteration.

Initially it will be important to offload the fascia and stop the aggravating activity, to give the structure a chance to recover. There are lots of treatments available, stretch and strengthening programmes, as well as deep soft tissue and joint mobilisation work.

Orthotics and foot supports, looking at what trainers best suit your foot type and a gradual return to training will need to be discussed with your coach. Make sure that the foot is strong enough to cope with the volume and speed at which you need to run.

Have you struggled with plantar fasciitis? Let us know in the comments below