Athletic Injuries Update: Plantar Fascitis

Plantar Fascitis is a very common disorder that occurs on the bottom of the foot. Usually pain begins at the heel. It works its way towards the inside arch and occasionally to the ball of the foot. There are many causes of plantar fascitis, treatment options, and ways to manage it on your own.

Anatomy:

The plantar aponeurosis, flexor digitorum brevis, and the quadratus plantae form a strong group on the bottom or plantar surface of the foot and are often the source of the problem when a diagnosis of “plantar fasciitis” is encountered. The plantar fascia is a thick fibrous connective tissue that lies on both sides of these structures listed, and acts to protect the bottom of the foot as it is the closes to the skin.

Definition & Discussion:

Plantar fascitis is a diagnosis that is associated with a sprain, intermittent associated inflammation, degeneration, and pain of some key muscles on the bottom of the foot. The plantar fascia on the bottom of the foot begins to undergo excessive tension, which causes chronic irritation and pain. Typically, people feel pain on the bottom of the foot after long term standing, walking, and early in the morning after waking.

Causes:

Whether you are an athlete or not, there are many potential causes for plantar fascitis if conditions are sufficient:

1. Excessive Tension: Excessive tension on the plantar aponeurosis on the bottom of the foot causes chronic irritation, which can lead to eventual traction heel spurs, degeneration, and pain.
2. Athletes: One of the most common overuse injuries in athletes, especially distance runners and basketball players.
3. Combination Injury: Plantar fascitis can accompany other foot and leg complaints such as achilles tendinitis, bursitis, and metatarsalgia.
4. Other potential causative factors: Improper footwear, prolonged standing (repetitive), pronation syndrome, tight muscles, weak calf muscles, hard surfaces, aging, and obesity.

History, Signs & Symptoms:

1. Pain for several days to several months in the heel, midfoot, and inside arch. Often becomes chronic or recurring.
2. No trauma – often comes on with no known cause.
3. Increased pain with initial standing, walking, running – will seem to improve as activity continues, then gets worse at the end of the day.
4. Tired, achy feet at the end of the day accompanied by foot cramps and heel pain.
5. Improves with rest.
6. Worst after short periods of rest (several hours). Intense pain when first bearing weight after sleeping, and then subsides within 5-10 minutes of walking around.

Management:

1. RICE: Rest, Ice, Compress, and Elevate
2. Ultrasound, Cold Laser
3. Manipulation of the foot, ankle, pelvis and lumbar spine
4. Kinesio Tape, Tear Drop Taping Procedure
5. Night splints
6. Myofascial release of intrinsic foot muscles, plantar aponeurosis/fascia, and calves
7. Donut/soft pad for under the heel if a spur is suspected to be present
8. Rehabilitation for strengthening the intrinsic muscles of the foot.
9. Orthotics

Dr. Sarah Ytsma currently practicing chiropractic in both Chatham and Blenheim. She takes a special interest in athletic injuries, as athletics were a large part of her high school and post-secondary school careers. She played 4 years of varsity softball as a fastball pitcher for the Wayne State University Warriors before attending chiropractic school in St. Louis, MO. While completing her chiropractic internship, Dr. Sarah was granted a position with Logan College of Chiropractics “Biofreeze Sports & Rehabilitation Clinic” as a senior intern to work with athletes from Mizzou and local high schools and colleges. You can find more info on Dr. Sarah at www.drsarahytsma.ca.