As a massage therapist, I am commonly presented with people who complain of sore feet. This complaint can sometimes develop into a chronic condition called plantar fasciitis. Plantar Fasciitis is very common and is defined as an inflammation of the plantar fascia – the tissue which supports the muscles of the feet. “Plantar” – the bottom of the foot, “fascia” – type of connective tissue, and “itis” – inflammation.
Symptoms of plantar fasciitis include pain and stiffness of the feet/heel with walking and standing especially in the morning. This pain may be constant or come and go, can be sharp or aching. Pain may reduce or disappear as you warm up. There is usually a tender point at the plantar fascial attachment. An ultrasound is sometimes performed to confirm the diagnosis.
Plantar fasciitis usually develops gradually over a period of time. It can be caused by
· An increase or change in activity
· Wearing shoes which do not provide enough support
· Poor biomechanics and muscle weaknesses
· Tight and inflexible calf muscles
· Stress fractures or heel spurs
· Playing sports on hard surfaces
People who pronate while walking/ running may place more strain on the plantar fascia which may increase the risk of plantar fasciitis.
What are the options for treatment?
This type of pain does not just go away by ignoring it or training through it. Treatment in the early stages of inflammation can prevent the condition from worsening or becoming chronic. Long term treatment option may involve a referral to a sports doctor who may prescribe a cortisone injection via ultrasound guidance or a cam boot for a period of time.
Treatment involves:
· Massage
· Rest
· Stretching
· Ice or Heat
· Taping the foot and ankle to offload the plantar tendon
· Biomechanical assessment to identify areas of weakness or imbalance
· A heel raise in shoes
· Anti-inflammatories
· A progressive strengthening program,
· Orthotics and shoe support
Massage in particular focuses in breaking up fascia tightness using myofascial release. While this can be painful during treatment it can provide relief. Massage treatment also involves loosening up the muscles of the lower leg including the hamstrings, gluteals, soleus, gastroc, peroneals, tibialis anterior, the flexor muscles on the bottom of the foot and the ankle joint.
Prevention is key!
The feet are often the most neglected part of the body; however they are integral to almost everything we do. Spending a few minutes each day rolling out the bottom of the feet with a mobility ball or golf ball prevents muscle and fascia tightening and foot pain, as well as increasing ankle flexibility.
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