As someone who has always had a passion for sport and fitness, I have had my fair share of experiences with pain and injury. Although in some people’s eyes this may not be ideal, I think it helps me relate to you better and get you back doing what you want more effectively. However, in saying that, what we shall discuss today I have been very fortunate to never have experienced, as I have been told it’s quite painful! Plantar fasciosis (PF), formerly known as plantar fasciitis or plantar heel pain.
Plantar fasciosis is a very common pathology affecting the sole of the foot. The plantar fascia is a thick band of connective tissue, which resembles tendon, and is vitally important in our foot biomechanics, both statically and dynamically.
It has often been thought that PF develops due to a failure to control the arch of the foot. This was hypothesised to result in repetitive micro-tears and ongoing inflammation. However, this is not supported by current evidence, as inflammation is rarely present on further investigation. This is why the name changed from plantar fasciitis (-itis meaning inflammation) to plantar fasciosis.
The more likely reason for developing PF is due to the degeneration of collagen, increased infiltration of chemical bi-products (e.g. ground substance), ingrowth of nerve fibres and blood vessels and calcification of tissue. What I’m getting at with this is that PF cannot be managed with some simple anti-inflammatories and rest, as this will NOT result in meaningful change! The good thing is that though seemingly complex, the treatment of PF doesn’t have to be complicated.
There are a mix of risk factors for PF, some of them are non-modifiable, such as age and how you’re built (morphology), but others are modifiable, such as your weight, movement restrictions and weakness, footwear and activity levels.
So, now you know the what, where and why of PF, let’s get to the how to diagnose and fix it!
Diagnosis is based primarily around clinical assessment alone which means scans, such as MRI or ultrasound are rarely needed. This means you can walk (or more likely hobble) off the street into your friendly physiotherapists office and get diagnosed and begin treatment today.
There has been recent evidence-based development in the treatment of PF. This involves the performance of a specific exercise program which aims to reload the affected fascia and stimulate a reduction in pain and improvement in function. This exercise routine has been shown to be time-effective and result in superior outcomes for patients at 3 months, compared to stretching alone. Adjuncts to exercise include, stretching, rolling out the PF and shoe inserts.
Now you’re full bottle on PF, good on you! If you have any further questions, don’t hesitate to leave a comment or message me directly and I’ll get back to you ASAP.
If you or someone you know is suffering from PF, get in touch and make an appointment at Roar Physiotherapy today!
Rathleff, M. S., Mølgaard, C. M., Fredberg, U., Kaalund, S., Andersen, K. B., Jensen, T. T., … & Olesen, J. L. (2015). High‐load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12‐month follow‐up. Scandinavian journal of medicine & science in sports, 25(3).
Wearing, S. C., Smeathers, J. E., Urry, S. R., Hennig, E. M., & Hills, A. P. (2006). The pathomechanics of plantar fasciitis. Sports Medicine, 36(7), 585-611.