Pain in The Foot?

What is plantar fasciitis?

The plantar fascia is a band of tissue called fascia that extends along the bottom of your foot, fanning out from the heel bone (calcaneus) to connect to all your toes. The plantar fascia supports the arch of your foot, contributing to everything you do on or with your feet throughout the day. Fascia is a type of connective tissue surrounding your muscles and nerves, helping to reduce friction and provide structural support. When ‘itis’ is added to the end of any medical word, like plantar fasciitis, it indicates inflammation, so plantar fasciitis is inflammation of the plantar fascia. You will most commonly hear symptoms of morning heel pain referred to as plantar fasciitis, but more commonly now we call this condition plantar fasciopathy. Fasciopathy is cellular structural changes in the fascia due to chronic overloading the tissue. After extensive research into heel pain and the fascia, researchers have realized that the fascia is actually most commonly thickened due to overuse not due to inflammation. 

What are the symptoms of plantar fasciopathy?

Plantar fasciopathy is identified by the intense pain and tension felt along the bottom of your foot and into your heel. Often that pain is worse in the morning when you first get out of bed, or after standing when you have been sitting for a while. The plantar fascia has been relaxed and shortened while you rest and when you stand on it, first thing in the morning or after sitting, you place the tissue under tension, which causes stretching of very sore irritated tissue. 

Why does plantar fasciopathy happen?

There are a variety of potential causes of plantar fasciopathy. It is more commonly related to repetitive movements, longer duration activities like running, hiking or dancing. Work that requires repetitive foot movement or standing for long periods of time can also be a risk factor. Similarly, wearing shoes that do not provide adequate support for your feet, being overweight and jumping into an activity too fast without preparing your body can also increase your risk. Often it is some combination of these risk factors that actually results in the plantar fascia getting irritated, e.g. you decided to run the TC 10k, bought new shoes, and ran the whole thing without training first.

What can you do to manage plantar fasciopathy?

Due to the nature of the plantar fascia being very active and necessary in springy like movements, jumping, running, hiking and dancing, you will often need to change your activity level or type of activity in order to lessen the impact of the condition for the short term. If you’re not sure how best to manage, a physiotherapy evaluation can help determine the underlying causes and best management strategies. You may find that a program of calf and foot stretching can help manage plantar fascia symptoms, but sometimes there is a need to add or adjust an orthotic, use a brace at night or some tweak to your shoe choices.

Plantar fasciopathy is a literal pain in the foot, but it can be managed and with appropriate support you can return to your preferred activities!