What is the Plantar Fascia?

It’s a thick bowstring-like ligament stretching underneath the sole, that attaches at the heel bone and connects to the toes. This thick weblike ligament acts as a shock absorber and supports the arch of your foot, helping you walk

What is Plantar Fasciitis and what causes it? 

It’s a condition that affects your plantar fascia ligaments, that most commonly causes heel pain but also arch pain, Achilles tendon pain and pain and stiffness of the entire foot. 

It’s mostly caused by strain injury resulting in micro tears to the ligament where it attaches to the heel bone or to other areas of tightness on the sole of the foot. It’s therefore a degenerative condition that becomes painful due to inflammation.

Too much pressure on your feet from daily wear and tear; repetitive strain injury from excessive running or walking; and inadequate foot wear, can all damage the ligaments and the plantar fascia.

Who’s mostly like to suffer from Plantar Fasciitis?

Unfortunately, it’s quite a common orthopaedic complaint, especially among runners and people who participate in high impact exercise/ sport. It can also affect people who have high arches, flat feet, or jobs where they’re standing for long periods of time. 

It’s also more common among menopausal women than younger women. Interestingly, more men report this condition than younger women. 

Oh, great, another awesome thing to look forward to in menopause then?

Unfortunately, yes! Although, as men get it too, it’s not solely limited to menopausal women.

Both ageing and reduced oestrogen impact the health of our skeletal tissues by affecting collagen production. 

Collagen’s the building block of our musculoskeletal system - bones, muscles, ligaments, tendons, and skin. 

Less collagen synthesis means reduced elasticity of tendons and skin; constriction of blood vessels; decreased healing; and an increased risk of developing a soft tissue injury and joint pain. Yay.

How to ease the pain and prevent or manage plantar fasciitis.

The NHS recommends the following:

Do

• rest and raise your foot on a stool when you can

• put an ice pack (or bag of frozen peas) in a towel on the painful area for up to 20 minutes every 2 to 3 hours

• wear wide comfortable shoes with a low heel and soft sole

• use insoles or heel pads in your shoes

• regular gentle stretching exercises of the feet and the calves .

• exercises that do not put pressure on your feet, such as swimming

• take paracetamol

Things to avoid:

• don’t take ibuprofen for the first 48 hours

• avoid walking or standing for long periods

• don’t wear high heels or tight pointy shoes 

• don’t wear flip-flops or backless slippers 

• try not to walk barefoot on hard surfaces 

Firstly, manage the initial flare up..

I found bottles of frozen water to be very soothing! Fill two 500ml bottles of water and keep them in the freezer. To use, sit on a chair and roll your feet back and forth over the frozen water bottles to ease the inflamed area. Try this a couple of times a day. The rolling action and the ice both act to reduce the inflammation.

I also found that athletic tape helped support the foot and keeps you from moving it in a way that makes the plantar fasciitis worse. Especially helpful during exercise!

Shoe inserts, insoles, arch supports, or orthotics, can give extra cushioning and added support. You can get them over-the-counter (OTC) or have them custom made. There doesn’t seem to be a big difference in efficacy between OTC and custom made.

When choosing, look for a firm insert with good arch support. Wear them if you’re going to be on your feet for a long period of time or going walking. I wear these indoors in my slippers during the initial flare up as well as in outdoor shoes when going out! 

If you don't fancy inserts, try heel cups. These raise your heel to relieve tension and give you extra cushioning. They often don't work as well as inserts, but they're a cheaper option. 

Most of us sleep with our feet pointed down, which shortens the plantar fascia and Achilles tendon. Night splints, which you wear while you sleep, keep your feet at a 90-degree angle to give you an overnight stretch. . And once the pain is gone, you stop wearing them. 

How can you prevent repeat Plantar Fasciitis flare ups?

The bad news is that it can take quite up to eighteen months to recover from plantar fasciitis. And, it's likely that unless you change your habits, you are very likely to experience future flare ups!

It's super important that you maintain your routine to stretch and strengthen your calves, Achilles tendon and your foot. This will assist to stabilize your ankle. Why not check out this post on stretching & foam rolling and this post to stretch and strengthen? 

If you're overweight, it's a good idea lose some weight as the extra weight puts more strain on the bottom of the feet.

Avoid high-impact activities like running and jumping as these put a lot of stress on your feet and can make your calf muscles tighter if you don't stretch them out. Go for lower impact exercises instead, and be sure to do some leg and foot stretches. Not quite sure what sort of stretches you should be doing? Check out this post .