Understanding Plantar Fasciitis: Causes, Symptoms, and Treatment Options

Do you struggle with heel pain? You’re not alone. In fact, it’s a problem that affects many people. But the good news is that there are simple, effective solutions to help you overcome this challenge. In this post, we’ll show you exactly how Physiotherapy can help to get rid of your nasty heel pain.

Is Chronic Heel Pain Common?

Chronic heel pain is probably more common than you think. a lot of people suffer from foot, toe, heel and ankle pain for years. This persistent pain can get in the way of your activities of daily living such as walking, going up and down stairs,  playing with your kids and grandkids, working out and any involvement in sports.

Can Plantar Fasciitis Be Treated by Physiotherapy?

Yes! Plantar fasciitis can be treated and managed conservatively by physiotherapy. Treatment is largely dependent on what the physiotherapist finds during your assessment, however, a combined approach is most commonly used involving a variety of interventions. These interventions include manual therapy (includes soft-tissue massage and joint mobilization), stretching, taping, foot orthoses if necessary, exercise, and lots of education about your condition and pain. 

Your physiotherapist may also use other modalities or acupuncture for pain relief. Since physiotherapists are movement and body experts, they can help to identify potential causes of your plantar fasciitis and can then work with you to build the optimal treatment plan. Without this expertise, you may be able to temporarily alleviate pain but may not be able to treat the condition entirely. 

What Is the Fastest Way To Relieve Plantar Fasciitis Pain?

Sometimes, the pain can get so bad that we need nothing more than immediate relief. In these situations, the fastest way to relieve plantar fasciitis pain is to simply rest, ice and self-massage. If necessary, NSAID medications such as ibuprofen (Advil) can also help to alleviate pain and reduce inflammation. 

Is It Good To Massage Feet With Plantar Fasciitis?

It is certainly helpful to massage feet with plantar fasciitis as this can help to relieve pain. It may feel a little uncomfortable, especially when adding pressure over the affected heel, however, there are ways to avoid this discomfort. The key is to start with a very small amount of pressure and then slowly increase this pressure as the pain improves. It is best to avoid pressing down on tender or sore spots as this will likely result in pain, but don’t be afraid to apply steady pressure over these areas. 

Since heel pain is often the worst in the mornings with the first steps, it can be helpful to massage your foot before getting out of bed. Massaging can help to stretch the tissues, increase blood flow to the area, and distract pain receptors in the brain, thus helping to make you feel better when putting weight on your heels and feet. 

What Are the Symptoms of Plantar Fasciitis?

The most common and characteristic symptom of plantar fasciitis is heel pain. This heel pain is typically worst when taking your first steps in the morning after waking up or after long periods of rest/sitting down. It will typically subside after a few minutes of walking but can also be triggered by long periods of standing or after periods of exercise and activity. Additional symptoms of plantar fasciitis include tenderness in the heel, stiffness in the ankle, a tight Achilles tendon, increased pain when barefoot on hard surfaces, etc.

Plantar heel pain and foot pain might be a symptom of plantar fasciitis, or it could be a symptom of tension through the inside of the ankle. this tension, and potential inflammation, through the inside of the ankle, near the ankle bone, can result in irritation of the tibial nerve and the calcaneal branch of the tibial nerve. this irritation leads to pain in the heel region, and can often be confused for a diagnosis of plantar fasciitis.

Foot pain symptoms can stem from issues in the toes, foot, and ankle, or even start up at the knee,  or hip, and radiate down to the foot.

What Not To Do With Plantar Fasciitis?

If you have plantar fasciitis, there are a number of things you should try to avoid in order to prevent yourself from triggering pain or making the condition worse. 

  • Avoid sitting or standing for long periods of time, as this can bring on the heel pain. It is best to change positions often and to take regular breaks.
  • Don’t push through the pain. If you are experiencing a flare-up or having an episode of increased pain, it is best to rest and take it easy.
  • Avoid walking for prolonged periods when in pain. Avoid walking barefoot on hard surfaces. This can result in increased pressure and thus, pain in your heel. 
  • Don’t ignore the importance of stretching! Stretching both the feet as well as the calf muscles regularly and especially before walking or running can warm up your tissues and help with pain relief. 
  • Avoid wearing unsupportive and worn-out shoes. It is better to wear shoes with thick soles and extra cushioning, as these can reduce the amount of tension and pressure on the fascia and heel, and can help with pain relief during walking and standing.

Thankfully there are some targeted approaches that we can use with Physiotherapy in Mississauga to get rid of this annoying pain. We can achieve pain reduction through Physiotherapy approaches that reduce inflammation in the ankle and foot,  exercises that improve the strength of the ankle and toe muscles, and stretches that improve the mobility in the lower leg. Your physiotherapist will also show you how to manage the pain at home and continue to improve your symptoms. In addition to an exercise program, this could be through the use of hot packs and cold packs, or contrast baths. 

Stretches for Plantar Fasciitis

Before engaging in any stretches, you should consult a professional, to make sure that these stretches are appropriate to you. 

Soleus Stretch / Calf Stretch

A common stretch prescribed for plantar fasciitis would be a Soleus stretch or a calf stretch. Both stretches can be performed in a runner’s lunge position with the symptomatic leg behind you. The difference is that with the Soleus stretch, you will put a bit of a bend in the knee to take pressure off the gastrocnemius muscle. Alternating between these two types of stretches can be beneficial to help relieve plantar fasciitis pain or heel pain. However Consulting a professional prior to engaging in these stretches is highly recommended, to make sure that these are appropriate for you.

Towel Stretch

Another commonly prescribed stretch to improve plantar fasciitis symptoms is the towel stretch.  This is where you sit with your symptomatic leg out in front of you and you wrap a towel around the balls of your foot. then you gently pull back on the balls of your foot to create a stretch through the plantar fascia and calf muscles.

Active Stretching Technique

One of the most effective stretching techniques, regardless of where it’s being applied in the body, is the active stretching technique. We often use this in the clinic and achieve fantastic results. This approach is excellent because it combines the lengthening of the muscle achieved through the traditional passive stretch, but includes muscle activation in the dynamic component, so you get the best of both worlds for optimal results.

Gentle stretching is important. Part of the improvements seen from stretching is the fact that the repeated motion will improve blood flow to the tissues and gently provide length and stimulation to some tight areas. With these stretches, you do not want to recreate your pain, but you may feel some gentle aching or pulling sensations, which are appropriate. Typically a stretch will need to be held for at least 20 to 30 seconds, and sometimes up to one or two minutes depending on the therapist’s preference and prescription, and the patient’s presentation. typically these stretches will be held for anywhere from 2 to 4 reps. make sure to consult a professional before engaging in these stretches on your own, to make sure that they are appropriate for you.

Final Words

We regularly see the amazing results that our patients achieve with the help of our clinic. From the weekend warrior and office workers to manual labourers, and professional athletes, our patients have transformed their lives through Physiotherapy. Don’t wait any longer to experience these results for yourself. Book your appointment now.

Special thanks to Rimsha Amin for their valuable contribution to this blog post.