Can a physiotherapist help with plantar fasciitis?
What we’ll cover
Can a physiotherapist help with plantar fasciitis?
Plantar fasciitis (fasciopathy) is a common source of heel pain. Common symptoms include pain and stiffness often first thing in the morning or with the first few steps following after sitting down. These symptoms often appear to warm up or settle as you continue to walk or run.
Physiotherapist Laura Scott identifies the best methods of treating and preventing plantar fasciitis.
What is plantar fascia?
The plantar fascia is a thick band of fibrous tissue that attaches from the heel and extends to the base of your toes. It acts to support the arch of your foot and shock absorb during walking and running.
Plantar fasciitis occurs with irritation or inflammation of the plantar fascia. There are a range of causes ranging from overload through to poor footwear. In some cases, bony changes including heel spurs can be contributing factors to plantar fasciitis.
What is the best treatment for plantar fasciitis?
Physiotherapy has been shown to be incredibly effective in the treatment of plantar fasciitis. Plantar fasciitis treatment is similar to the management of tendon pain. This includes managing the initial symptoms followed by gradually loading soft tissue to promote strengthening in order to prevent reoccurence.
Plantar fasciitis treatment
The first stage of treatment is to reduce symptoms such as pain and stiffness as quickly as possible. Using an ice pack is a simple and effective method to reduce pain. Rolling a frozen drink bottle can be an great way to ice whilst gently massaging your plantar fascia. In some cases, anti-inflammatory medication can be used to assist with the pain.
Techniques that your physiotherapist may utilise to reduce pain include joint mobilisations for stiff joints, massage and dry needling. Depending on the cause of your plantar fasciitis, taping, braces or heel cups can be utilised to support and protect the plantar fascia. Flexibility exercises for the calf can also be beneficial. This includes using a foam roller or calf stretches. Try holding the stretches below for at least 15 sec, 4 -5 x day.
The second stage of rehabilitation is rehabilitate and progressively load the plantar fascia through gradually loading and progressives exercises. An exercise that is specifically used to load the plantar fascia includes a heel raise with an elevated big toe. Elevating the big toe onto a towel or dowel places more load specifically through the plantar fascia. This exercise can be commenced using both feet before progressively moving to the affected leg.
Your physiotherapist will also address other factors which may be contributing or causing plantar fasciitis. Commonly these can include decreased joint flexibility through the big toe or ankle, poor footwear and reduced muscular strength or endurance.
Should I stop exercises with plantar fasciitis?
Continuing to exercise is important in the management of plantar fasciitis. Just like management of tendon injuries, we know that overloading and underloading can actually increase symptoms and the time it takes for healing. A good rule of thumb is that exercise can continue as long as morning pain and stiffness does not increase the following day. Consider modifying the distance or speed that you have been walking or running to ensure that pain does not increase several hours following exercise or the following day. In some cases, cross training exercises such as cycling or the elliptical machine are good methods to continue exercise.
Your physiotherapist is well placed to assist in the management of plantar fasciitis. If you are experiencing foot or heel pain, contact our team or book online.
