Plantar fasciopathy is the most common cause of plantar (under-side) heel pain. It is an overuse condition of the plantar fascia at the attachment to the heel. The plantar fascia is involved in foot biomechanics as it provides arch support and absorbs shock throughout gait.
People with low arches or flat feet can have an increased risk of developing plantar fasciopathy as this causes increased stress on the origin of the plantar fascia. The condition is more commonly seen in running, dancing or excessive walking in poorly supportive footwear as these activities place increased loads through the foot. Due to the cause and nature of the condition, load control is important in managing symptoms and resolving the injury.
Initial treatment will usually consist of:
- Strength and loading program
- To improve the plantar fascia’s ability to absorb load, which is reduced in plantar fasciopathy
- Reducing excessive loads on the plantar fascia
- Typically this will include some form of activity modification of impact based activities such as running. However, some load is usually better than no load and often a reduction rather than full cessation of activity is necessary. Ascertaining ‘ideal load’ is a difficult task, however your Physiotherapist will be able to help you with this
- Taping can be used successfully as an adjunct to offload the plantar fascia and help improve pain with everyday walking
- Manual therapy
- This may include soft tissue work or joint mobilisations for symptom relief and foot mobility
In short, whilst plantar fasciopathy can be a very painful condition, it is traditionally very treatable. Pain in the area is often a sign that load in the area is not distributed as well as it could be and/or the plantar fascia has become intolerant to your load demands. This occurs when loading behaviours change rapidly. Poorly distributed load, load capacity of the plantar fascia and management of loading volumes will all form part of a structured, individualised rehabilitation program that will help you not only resolve the condition but prevent future episodes.