Assessing The Cause of Plantar Fasciitis
Plantar Fasciitis is pain along the bottom of the foot caused by inflammation of the plantar fascia connective tissue. Chronic cases often involve a resultant heel spur increasing related calcaneal pain.
Patients frequently report pain worse in the mornings with their first few steps out of bed. This complaint is most commonly resulting from the excessive inflammation at the calcaneal attachment point of the plantar fascia.
Body habitus is a possible cause of plantar fasciitis in overweight or obese patients as well as pregnant women who gain weight at a rapid pace. Added weight on the feet will stress the ligamentous and tendinous structures through all weightbearing activities.
Likewise, repetitive micro-trauma such as running, standing or jumping can create similar stress forces on the feet.
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Gait assessment and foot examination are critical diagnostic tools in plantar fasciitis.
Overpronation during stance phase gait causes repetitive lengthening of the entire foot structure.
The Windlass Effect response of the plantar fascia then causes repetitive contracture of the plantar fascia in its attempt to correct the biomechanical fault. This cycle of dysfunction stresses the plantar fascia causing inflammation and pain.
Treatment programs for the condition normally involve stretching and strengthening exercises such as wall stretches or stair stretches. These are recommended to correct the weakness of the foot muscles and to increase flexibility of the calf muscles.
Arch taping is another highly recommended form of treatment which helps in restricting the stretching of the plantar fascia ligament.
Custom orthotics help to control overpronation, increase shock absorption and correct foot position, reducing the arch strain associated with plantar fasciitis.
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