Have you ever stepped out of bed first thing in the morning and felt a searing pain in your heel? You may have even looked down to confront the sharp toy truck or shard of glass that MUST be on the floor….there is nothing there, it’s an internally generated pain that feels like a cattle prod to the foot every time you plant your foot down
The very likely diagnosis here is Plantar Fasciitis.
You may hobble around for 10-30 minutes until it frees up and then your symptoms may peak and trough throughout your day depending on the severity of symptoms and your activity levels.
The thing about plantar pain is that often we can warm it up enough to ignore it and run through it, (that is until the next morning when we take the first step out of bed) to a ‘good morning knife stab’ on the sole of your foot.
And so the saga goes on….until we rehab it so you can walk around and run footloose and fancy free.
This condition accounts for about 10% of Runner related injuries! In middle to long distance track runners this statistic may be as high as 22%. It’s a pest of an injury and will continue to bite you until you address the symptoms, the causes and take a preventative take on it’s management. (Spoken from clinical and first hand experience.)
Firstly, let’s take a closer look at what plantar fascia structure actually is:
The plantar fascia is a thick connective tissue which runs form the base of the heel bone (calcaneus) to the base of the toes and supports the arch of the foot. There are three distinct components of the plantar fascia (medial, central and lateral.) It’s a fan shaped ligament which has a key structural role in foot mechanics and often goes unnoticed until it flares.
The most common area of the Plantar Fascia to become inflamed is the medial and central portion which is why symptoms often present on the inside portion of the heel below the main arch of the foot.
The plantar functions both statically and dynamically. While standing still the plantar helps support the arch of the foot. When walking, running or jumping the plantar fascia helps absorb load like a spring to assist in the propulsive phase of gait.
The plantar fascia is also closely connected to the achilles tendon at the back of the heel also as there are continuous fibres which run from the achilles to the origin of the plantar at the base of the heel. This is why tight calves and achilles can contribute to extra tension in the plantar fascia.
What is plantar fasciitis?
’Itis’ simply means inflammation so if we team that with fascia (the fibrous connective tissue on the Plantar/underside surface of the foot- we have inflammation of the heel aka “Plantar Fasciitis”. This is often an overuse injury that is primarily due to repetitive strain causing micro-tears of the plantar fascia, but can occur as a result of trauma or other multifactorial causes. The most common area of the Plantar fascia to become inflamed is the medial and central band so symptoms normally arise on the medial (inner) and central parts of the heel.
About Alice Baquie
Alice has been a physio for fourteen years and specialises in injury prevention and management for runners. Alice has represented Australia in distance running and gymnastics so has sound knowledge of athletic performance and understands the importance of strength conditioning and mobility to help keep the body moving effectively to mitigate injuries.
Alice, otherwise known to her wonderful pilates community as AB is a fun loving inclusive person always ready to chat and have a laugh and has hosted 1000’s of online classes which attract people from all around the world, including 25 Aussie Olympians.