Friday, May 4, 2018

Plantar Fasciitis: More Than Just a Footnote

by James Bansberg, DPT
Feet: so far away and often overlooked…until you wake up one morning and realize it’s impossible to place any weight through your foot. Feet are our foundation - our body’s connection with the earth - yet we place them in tight, uncomfortably angled, or worn down shoes, and refuse to maintain them the way we do other body parts.  Considering that plantar fasciitis is the leading cause of heel pain, and affects more than 2 million people in the US, it may be time to give this hard-working appendage a little more love.  

The plantar fascia is made up of thick fibrous bands of connective tissue that act like a cable between the heel and toes. These bands work hard, acting as shock absorbers, foot stabilizers, and arch supporters. Since we can be so unforgiving to our feet, there are multiple impairments that can lead to aggravation of the tissue. So what kind of risk factors should you be looking for in order to get to the root of the cause?
  • Poor ankle and toe mobility
  • Ramping up activity too quickly (marathon training!)
  • Obesity
  • Age (typically 40+)
  • High or low arches
  • Stiff/cramping calf muscles
  • Prolonged daily standing on hard surface
  • Improper footwear (worn, poor fitting, high heels, low support)

The presence of any of these risk factors can lead to plantar fasciitis, and many of us have more than one. Fortunately, there are just as many options to reduce risk: stretching and strengthening muscles that may be cramping or that don’t get much opportunity to be fully stretched often helps, as does rest. Proper shoe fitting (as well as replacing stressful footwear with more supportive options) can dramatically reduce risk, and if obesity is a factor, weight loss may help as well. Depending on the severity of pain, your doctor may recommend other options, such as night splinting.

If you have foot pain, however,evidence suggests that physical therapy will help you recover faster and cost you less than if you do not receive treatment. Experienced therapists at Lakeshore Physical Therapy will administer a comprehensive evaluation to determine impairments and utilize current evidence and proper treatment to help lower pain and improve function.  

“Utilization of Physical Therapy Intervention Among Patients With Plantar Fasciitis in the United States” (J Orthop Sports Phys Ther 2017;47(2):49–55. doi:10.2519/jospt.2017.6999).