What is it?
Plantar fasciitis (PF) is reported to be the most common cause of chronic inferior heel pain. Risk factors include obesity, occupations with prolonged standing, flat feet, limited ankle dorsiflexion, plantar heel spurs and running.
Generally, PF is thought to be a self limitting condition, usually settling after 12 months.
It usually presents as sharp pain in the heel on the first few steps in the morning and after prolonged sitting, normally improving after a couple of minutes.
Treatments
Shockwave therapy
Taping
Taping technique using kinesiotape for offloading plantar fascia or supporting the medial arch may be helpful for some patients.
Stretching
It has been theorized that inflexibility of the gastroc-soleus complex can lead to excessive pronation and overcompensation of the plantar fascia at the first metatarsal phalangeal joint, therefore increasing the stress at the medial calcaneal insertion. Therefore, it is deemed that gastrocnemius-soleus stretches are a beneficial treatment in the initial stage of a plantar fasciitis treatment or rehabilitation program
Stretching of the plantar fascia itself can also be useful by crossing the foot over the opposite knee and flexing the great toe. Hold 20 seconds.
You can also stretch this area by massaging the plantar fascia with a tennis ball or a bottle of water which has been frozen (allow it to defrost for a few minutes to avoid ice burns).
Strengthening
High load strengthening of achilles tendons has been shown to be effective in reducing pain of patients with tendonitis. A recent paper by Rathleff et al. has shown a way to adapt these loading exercises to have an effect on the plantar fascia too. High load strength training is thought to stimulate collagen synthesis and therefore may improve the ability to tolerate load.
References
http://www.running-physio.com/pf-new-research/
Chang K.V., Chen S.Y., Chen W.S., Tu Y.K., Chien K.L. Comparative effectiveness of focused shock wave therapy of different intensity levels and radial shock wave therapy for treating plantar fasciitis: a systematic review and network meta-analysis.Arch Phys Med Rehabil. 2012;93(7):1259–1268.
Rathleff MS, Mølgaard CM, Fredberg U, et al. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Spor 2014:n/a-n/a doi: 10.1111/sms.12313[published Online First: Epub Date]|.
Siobhan White 