What is Plantar Fasciitis?

The Plantar Fascia is a thick band of connective tissue that supports the arch of the foot.  This band of connective tissue runs along the bottom of the foot from the heel to the toes.  The plantar fascia is an important energy storing structure acting like a spring to assist pushing off of the foot during walking and running.  Plantar fasciitis occurs when this band of tissue is overloaded and becomes inflamed or irritated.

What Are The Symptoms of Plantar Fasciitis?

1. Pain on the bottom of the foot towards the heal.
2. The pain is usually worse with the first few steps in the morning or after sitting for a long time.
3. Increased pain after weight bearing exercise.

What Are The Possible Causes Plantar Fasciitis?

The possible causes are:

1. Abnormal foot mechanics such as excessive pronation (flattening)
2. Abnormal hip and knee mechanics placing increased stress on the foot.
3. Tight calf muscles placing increased stress on the foot.
4. Wearing shoes that lack arch support.
5. A sudden increase in weight bearing activities such as running.
6. Weight gain placing more pressure on the feet.
7. Pregnancy due to added weight and softening of the plantar fascia due to hormonal changes.

How is Plantar Fasciitis Treated?

We have found the EdUReP (Education, Unload, Reload, Prevention) model to be very effective for treating Plantar Fasciitis.

1. Education: The patient is educated regarding predisposing factors and mechanical faults that may be contributing to overload of the plantar fascia.
2. Unload: A period of rest is recommended and the plantar fascia is unloaded by improving hip and knee mechanics as well as stretching the calf muscles.  Calf stretches must be altered to isolate the stretch to the calf without stretching the plantar fascia (see our self management hand out).  We do not recommend stretching the plantar fascia because we feel that excessive elongation of this tissue is the cause of the pain in the first place.  Orthotics may also be necessary to help unload the plantar fascia.  The pain can often be managed with ice and self massage.
3. Reload: Once the pain is diminished wight bearing exercise is slowly reinstituted into the patients program.
4. Prevention: The patient is further educated regarding ways to prevent recurrence.  This includes instituting recovery weeks into their training program and exercises to maintain proper mechanics of the lower extremity.

We’ve made a self-management handout for treating plantar fasciitis. Click on the link to download.

If Pain Persists and You’re In the Denver Metro Area

Schedule an appointment with our staff of licensed Physical Therapists. We’ll do a thorough exam and evaluation and suggest a course of treatment. If you’re not local to Belmar Physical Therapy then please contact a local, licensed therapist in your area.