Plantar fasciitis is a painful condition caused by inflammation of the thick, fibrous band of tissue (”fascia”) that reaches from the heel to the toes. This fascia is responsible for supporting the muscles and arch of the foot. The plantar fascia is made of three distinct parts: medial, central, and lateral bands. The central band is the thickest and strongest and is most likely involved in plantar fasciitis pain. Tiny tears are created on the surface of the fascia when it’s stretched too far causing inflammation and pain. In addition to inflammation and pain, the stress on the muscles and ligaments from plantar fasciitis can cause heel spurs. There isn’t a single treatment for plantar fasciitis, but physical therapy utilizes several tools which can alleviate the pain and inflammation.
Plantar Fasciitis accounts for about 10% of runner related injuries and is more likely to affect women than men. Because of the high incidence rate of plantar fasciitis in runners, the primary cause is believed to be microtrauma from repeated stress.
In normal function, the plantar fascia acts as a shock absorber and support for the arch of the foot. While walking or moving, the plantar fascia is like a spring that simultaneously conserves energy and provides propulsion. Tension increases while the foot is on the ground and is then released during toe-off to help with acceleration.
5 Modalities to Treat the Pain of Plantar Fasciitis
1. Kinesio Tape: Evidence has shown using Kinesio tape is effective alleviating pain and promoting the healing process. The Kinesio tape provides support for the arch allowing the foot to relax, which relieves pressure and the fascia and reduces inflammation.
2. Cold Compression Therapy: Cold compression therapy combines the benefits of ice which helps decrease pain along with compression which helps decrease edema and swelling. Cold compression therapy is useful when treating acute pain from plantar fasciitis, particularly following any stretching done to the foot during a physical therapy session.
3. Ultrasound Therapy: Using sound waves ultrasound therapy stimulates the tissue beneath the skin’s surface. The heating effect of ultrasound therapy aids in increasing blood flow in the plantar fascia which helps reduce swelling and edema, leading to a reduction in pain.
4. Low Level Laser Therapy: Laser therapy applies light (red and infrared) over the plantar fascia. Laser therapy converts light into biochemical energy, which initiates tissue repair in the cells. Additionally the stimulation created by the laser helps reduce pain and decrease inflammation.
5. Therapeutic Stretching: Once the acute pain of plantar fasciitis has been addressed, it becomes important to stretch the calves and feet in order to relieve the pressure on the plantar fascia.
Another one of the primary populations affected by this ailment are those who are overweight. The pain caused by plantar fasciitis makes it difficult for this population to exercise making a cycle of not enough movement but being stopped by prohibitive pain. It’s important for people experiencing symptoms for longer than a week to seek treatment from a physical therapist in order to reduce down time and increase the ability to return to normal activities.