Foot pain can be debilitating, not to mention downright annoying. When you add chronic pain and minimal relief, you’ve created a recipe for misery. If you’re noticing the bottom of your heel or the arch of your foot hurting, especially first thing in the morning or after long periods of standing, you could be suffering from one of the most common orthopedic conditions: Plantar Fasciitis.
The plantar fascia is a thick, weblike ligament in the bottom of your foot that runs from your heel to your toes. The primary job of the plantar fascia is to support your arch and act as a shock absorber as you perform activities of daily living as well as to stabilize the foot when you push off. However, if too much tension or stress is placed on the plantar fascia, especially repeatedly, then small tears can occur. This causes irritation and inflammation that can become quite severe.
Each personal “cause” for plantar fascia is likely different as there are multiple factors that can make one more susceptible. Certain types of exercise such as running, CrossFit, and aerobic dance can all place an excessive amount of stress on your fascia resulting in injury. In addition, faulty biomechanics can affect the way weight is distributed and can add stress to the plantar facia. This can include flat feet (pes planus), high arches (pes cavus), tight calves. or degenerative changes and alignment issues of the rearfoot and forefoot. Other causes can include obesity, and age, being that plantar fasciitis is most common between the ages of 40 to 60 and more common in females.
Depending on your circumstance, pain may occur first thing in the morning, after long periods of standing, or after prolonged activity and most often, the pain is the worst within the first few steps in the morning, but gradually decreases as you get moving. The pain can return later in the day with weightbearing activities. Often times, pain isn’t felt during exercise, but rather afterwards and is normally described as a stabbing pain at the bottom of the foot near the heel. This may also include a residual aching, throbbing, or burning sensation.
Understandably, most individuals try at-home remedies to curb their plantar fasciitis pain before pursuing conservative treatment. Most folks don’t seek clinical treatment for a year, but with the use of ice, NSAIDs, and active rest, the average resolution time for PF is 6-18 months. If you’re able to use these remedies right as you begin to experience pain, you’re more likely to see relief than if your pain is already chronic in nature (re-occurring pain for 6-8 weeks). Reducing your activity level to alleviate extra stress on the plantar fascia is essential in promoting the healing process. Icing for 15-20 minutes 3-4 times daily will help control the inflammation and decrease the pain. Specific stretches and exercises can reduce tension in your foot and calf to offer rapid pain relief and improvement of symptoms over a period of time. These can be performed 2-3 times daily but should not be painful. See the exercises and stretches here! https://www.medicalnewstoday.com/articles/324353
When self-management options are not providing relief or improvement in symptoms, physical therapy should be your next stop. Jacob Treadway PT, DPT, here at TSMG discusses how we treat plantar fasciitis:
“Being the premier foot and ankle treatment facility in Knoxville, we specialize in all injuries and conditions of the foot and ankle. We determine the faulty biomechanics unique to each individual whether it be pes planus (flat feet), pes cavus (high arches), or faulty gait mechanics. We will then be able to correct these faulty biomechanics with custom foot orthotic intervention (what people often refer to as “inserts”) and proper supportive shoe education. All of which will directly reduce the stretch and stress being placed on the plantar fascia. This sets the body up for an appropriate healing environment.
Secondly, we will utilize our diagnostic ultrasound to determine the exact nature of the injury- micro tear, full tear, fasciosis (degeneration), fasciitis (inflammation) or other. This will allow us to develop an effective treatment plan of care.
Thirdly, our expert staff will provide hands-on manual therapy treatment consisting of deep soft tissue massage, Western dry needling, cold gas laser, ASTYM, Chinese cupping, and more designed to promote blood flow, reduce swelling and pain, and overall, promote healing. Our one-of-a-kind biomechanical lab will then be used specifically to map out pressure areas on the bottom of your feet using our plantar pressure mapping mat. Then your gait (walking or running) will be filmed, analyzed, and you will be provided with coaching to correct faulty mechanics. This helps you use your foot the way it was designed. Lastly, a unique loading strategy will be used consisting of therapeutic stretching (Active Isolated Stretching) and exercise training (CHECK certified, triplanar, functional) program with the ultimate goal of returning you back to your desired hobbies and recreation.”
Jacob Treadway PT, DPT
Written by: Mei Krusenklaus