Plantar Fasciitis
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The plantar fascia is a dense band of tissue that runs from the calcaneus to the heads of the metatarsals of the foot. This tissue functions as the construct of the longitudinal arch of the foot. The plantar fascia is also responsible for locking the foot in supination prior to push-off in running. Excessive stress can be applied to the plantar fascia when the foot is in excessive pronation, causing the arch to flatten. Plantar fascia injuries are usually chronic in nature; that is, excessive stress over time causes the plantar fascia to become inflamed. Less often, a traumatic injury can cause a plantar fascia tear. These types of injuries are usually associated with falling and landing on one foot, or landing on an object that tears the plantar fascia. The symptoms of chronic plantar fascia include burning pain at the insertion of the plantar fascia on the calcaneus, morning stiffness, pain while walking on the toes, pain while a stress is applied to the foot (i.e. football lineman’s stance), pain while changing direction. Signs of the injury include: local tenderness at the insertion of the plantar fascia on the calcaneus, pain with passive toe extension, and possibly localized inflammation. Most often, the cause of chronic plantar fascia is a combination of poor footwear choices and lack of calf flexibility. The gastrocnemius/soleus complex attaches on the calcaneus. There is a link of connective tissue that runs from the insertion of the Achilles Tendon to the attachment of the plantar fascia. When the calf musculature is too tight, the plantar fascia begins to tighten, causing pain. Improper shoe fit should also be investigated. If the shoes are placing the athlete in a pronated position (weight bearing more on the inside of the heel), the plantar fascia takes more stress with each heel strike. This over time can lead to plantar fascia inflammation and pain. This athlete should choose a more neutral shoe. TreatmentTreatment for plantar fascia begins with early recognition of the cause. Removal of or removal from the source of the stress is extremely important. If the shoes are a problem, purchase properly fit and structured shoes for the athlete’s feet. Stretch the calf musculature, including the Achilles Tendon. Perform one stretch with the knee straight to stretch the upper calf. Perform a second calf stretch with the knee bent to stretch the Achilles Tendon. Hold each stretch for 15 seconds and repeat 5 to 10 times. Stretching of the plantar fascia should also be included in the rehabilitation protocol. To stretch the plantar fascia, place the affected foot near the junction of a wall and floor. Place the toes on the wall and slowly slide the toes down the wall stretching the bottom of the foot. The muscles of foot and toes should be strengthened. Strengthening of the toe flexors can be accomplished by performing paper pick-ups and towel crunches. The athlete should be perform 30 to 60 paper pick-ups and 30 to 60 towel crunches daily. The calf muscles should strengthened. Performing calf raises will accomplish this. Calf raises should be performed in appropriate footwear. Performing calf raises with out arch support will cause undue stress and increase the pain in the arch. Performing 10 - 60 calf raises per day as pain allows is appropriate. Taping the arch or fitting the athlete with orthotics will take more stress off of the plantar fascia. Plantar Fascia Taping (Note: This page contains large graphics, it may take a while to load)
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©2000 - 2006 David Edell Information on this site is not a substitute for physician directed care. Please consult your personal physician for more detailed information concerning specific injuries or illnesses. Last Update for AthleticAdvisor.com: 06/04/2006 12:01:52 PM |
