Pain in the Arch
Plantar Fasciitis:
One of the more common foot complaints is pain underneath the foot, either in the middle of the arch itself, or where the arch meets the heel bone. In plantar fasciitis, the supportive ligament sheath (known as ‘fascia’) on the underside of the foot becomes overloaded and develops inflammation. This inflammation and irritation is often indicative of small tears throughout the fascia. Sometimes, if left long enough, the body will undergo changes in an attempt to stabilize the fascia by growing bony projections from the heel (known as ‘heel spurs’). Unfortunately, these spurs often only increase the discomfort and simply cutting out the heel spur surgically generally doesn’t fix people’s symptoms.
Sign and Symptoms:
Plantar fasciitis pain is usually described as:
- Sharp heel pain
- Worse in the morning or after a long period of inactivity
- Generally as you get moving the pain resides to a point
- Condition usually develops gradually over time
Contributing Factors:
Some of these potential causes include :
- Poor lower limb biomechanics, such us over-pronation during gait
- Tight and/or weak calf muscles
- Poor footwear
- Excessive changes in training loads
If the cause is not correctly identified, treatment only provides short term relief. Hence, a thorough biomechanical examination of client’s lower limbs and feet should be undertaken.
Management:
Identification of all contributing factors is vital to guide correct management. This includes:
- Education regarding activity modification and correct training loads
- Strengthening and stretching of appropriate lower limbs structures
- Application of correct footwear and orthotic prescription
Take-home message:
Plantar Fasciitis is a common foot condition that requires a thorough examination to diagnose the cause and what lead to its development in the first place. If you are experiencing any type of foot pain, management of all contributing factors down the kinetic chain is essential to ensure full rehabilitation and return to your desired sport/activity pain free.
Josh Kestenberg
Physiotherapist