By: Dr. Brian P. Kinmartin, PT, DPT, MTC, OCS, STC, CWcHP, Cert. DN
One of the most common causes of foot pain that affects roughly two million Americans a year and 10% of the population during their lifetime is known as plantar fasciitis. Plantar fasciitis is a painful inflammatory condition of the thick band of tissue (fascia) on the bottom of the foot, which runs across the bottom of the foot and connects your heel bone to your toes. Under normal circumstances, the plantar fascia acts like a shock absorber on the bottom of the foot with walking, weight bearing and running activities. When your heel strikes and hits the ground with walking or running activities, your body weight is put down through your foot, as you roll up onto your toes the plantar fascia stretches and absorbs the energy of the body, then as you roll up on to your toes that energy is transmitted through the plantar fascia as your foot pushes off. Therefore the main job of the plantar fascia is to absorb and transmit energy with weight bearing, walking and running activities. Like all tissues, if the tension becomes too great or occurs too often, it can create small tears in the fascia. One of the activities that can cause this is running. Repetitive tearing can cause the fascia to become chronically irritated or inflamed, resulting in plantar fasciitis.
Plantar fasciitis is most common between the ages of 40 and 60, it seems to occur more often in women than men, it is more likely to occur in people who are obese or who have a high body mass index, and it is more prevalent in people who perform activities that place a lot of stress on the heel bone and the attached tissues, such as runners and people with occupations that require a lot of walking or standing on hard surfaces, such as factory workers, teachers and waitresses. People who have faulty foot mechanics also are predisposed to suffering from plantar fasciitis. If you are flat-footed, or have a high arch or even just have an abnormal walking pattern, it can unevenly distribute your body weight when you are up on your feet, putting added stress on the plantar fascia making you more susceptible to injury. Improper shoe wear and fit is another factor that can make you more susceptible to plantar fasciitis. Shoes that are thin soled and have poor arch support lack the ability to absorb shock when on your feet, if wearing shoes with high heels, the achilles tendon or the thick tendon attached to the back of the heel can shorten, causing strain on the tissue around the heel, which includes the plantar fascia.
The symptoms of plantar fasciitis include foot pain that usually develops gradually; it usually affects just one foot, although it can occur in both feet simultaneously. It usually is worst with the first few steps in the morning after waking, and can be triggered by long periods of standing. Another factor contributing towards plantar fasciitis is loss of ankle mobility, especially the motion of dorsi-flexion, or a decreased ability to lift the foot bringing your toes up towards your head. This can be due to a tight achilles tendon, which attaches to the heel bone. A tight achilles tendon pulls the foot downwards towards the floor making it tough to lift the foot the opposite way. This can cause excessive stress to the plantar fascia, resulting in chronic injury and inflammation.
One extremely effective form of treatment for plantar fasciitis is Physical Therapy. Physical Therapists are skilled medical practitioners trained in biomechanics and human anatomy. At your initial consultation the Physical Therapist will perform a mechanical examination of your foot and ankle attempting to determine the exact cause of the irritant to the plantar fascia. Modalities such as ultrasound may be used to break up scar tissue, promote healing, and increase blood flow in the area. Dry Needling and soft tissue mobilization may be used to help reduce muscular tightness and tension in the plantar fascia. Phonophoresis a combination treatment using the penetrating thermal effects of Ultrasound in combination with the transdermal drug delivery method of an anti-inflammatory hydrocortisone cream can be used to assist with increasing tissue mobility, decreasing swelling and inflammation. Joint mobilization and manipulations may be used to improve ankle mobility, along with instruction in therapeutic exercises and stretching to the plantar fascia and achilles tendon to improve ankle and foot alignment. Therapists may also use athletic taping techniques to temporarily support the bottom of your foot, limiting stress to the plantar fascia and allow healing.
So you see, there is a lot Physical Therapists can do to help. Weather you are an avid runner, an athletic senior, a weekend warrior, or just someone that loves to take an occasional walk. There is no need to limit your activity secondary to foot pain. Contact your local expert Physical Therapists at Professional Rehabilitation Services so we can help.
For further information on this or other related topics you can contact Brian P. Kinmartin, PT, DPT, MTC, OCS, STC, CWcHP, Cert. DN, at Professional Rehabilitation Services (Pawleys Island) (843) 235-0200, Kristen Lies PT, DPT (Murrells Inlet) (843) 314-3224, Richard A. Owens, PT, MS, OCS, Cert. SHT, CWcHP, Cert DN (Surfside) (843) 831-0163, or Richard DeFalco, DPT, OCS, CSCS, CWcHP, Cert. DN (Myrtle Beach) (843) 839-1300, or visit our website at www.prsrehabservices.com where you can learn more about the company and even download a referral form for your physician to fill out. You can also call and contact any of our offices and schedule a free 15-minute consultation to discuss your pain or dysfunction with a therapist!