What is plantar fasciitis?And How to prevent it?
Plantar fasciitis is none other than foot disorder in which the plantar Aponeurosis or the plantar fascia gets inflammed .
Causing heel pain in the morning and can increase during the whole day as well.
It is also called the policeman’s heel.
Plantar fascia alignment?
It is a bundle of collagen fibers or an Aponeurosis which maintains the arch of foot.
Mainly the medial longitudinal arch of foot.
It begins posteriorly on the medial tubercle of calcaneus .
And attaches anteriorly to the digits of foot via the plantar plates .
Terminates at the proximal phalanx of toe.
Also there is thick elastic multilobular fat present here which is responsible for absorbing about 110% of bodyweight while walking. This was the whole alignment of plantar fascia.
Why plantar fascia is important biomechanically?
It is important for a perfect arch of foot and also its alignment for weight bearing activities like running, jogging and many more .
Its main function are as follows:-
-Dampen the impact of weight bearing forces
-Dampen the rotational movements
-Adapt to changes in supporting surface.
-Distribution of weight through the foot for proper weight bearing.
It is a main component for a windlass mechanism or the tie-rod or tie-beam mechanism.
In which the plantar fascia acts as a tie rod and accordingly it lengthens or shortens depending upon the activity performed by the foot.
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Who are at more risk for developing a plantar fasciitis?
It can develop due to any unknown reason but we will see who are at more risk.
- People between the 40-60 years of age are more prone to develop plantar fascitis.
- Any foot deformity like Pes cavus /High arched foot or Pes planus/flat feet can cause it.
- Stiffness or weakness in the calf muscles like Gastrocnemius, soleus and also Achilles Tendon .
- Prolonged activity like standing at one place , running or even jogging for a larger duration can cause it.
- It can be congentinal as well.
- High body mass index or due to obesity , it can cause plantar fascia.
- The type of shoewear , epecially the sole inside it matters the most. The alignment of medial curve for medial arch of foot and curve for heel as well is equally important.
What are the first home remedies for plantar fasciitis?
Talking about plantar fasciitis there are alot of things people used to use from earlier days and it is suprising to know their effects as well.
- Applying lavender essential oil as it has an anti-inflammatory properties .
- Gently stretching the plantar fascia
- Icing the whole area for the inflammation to be reduced.
- Changing your old running shoe to a more advanced shoe.
- Taking rest so that the body automatically heals it .
- Having pain killers like NSAIDS (Non-steriodal anti-inflammatory drugs) like ibuprofen if you have unbearable pain .
- An the last as advised to almost every patient is reducing his/her weight.
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How the diagnosis of plantar fasciitis takes place?
Whenever a patients comes , these are following protocols for diagnosis.
Patient history like his/her name , age , sex and occupation are the primary key points of patients history.
Then the physical test is performed on the patient.
- They have tenderness on the antero-medial side of calcaneum bone.
- Pain increases when the therapist increases the dorsiflexion at ankle joint because it stretches the plantar fascia more thus increasing the pain.
- Tell the patient to stand with feets joined. The therapist will stand besides and checks medial arches of foot .
- Ask the patient to walk a few distance or stand for 3-4 minutes at one position, this increase the pain thus pointing that the patient has been diagnosed with plantar fasciitis.
- Further more , radiography , ultrasound and MRI would be sufficient for diagnostic purpose.
What role does a physio play in plantar fasciitis condition?
As earlier mentioned , after the clinical findings and assessment of plantar fasciitis.
He can do a lot many things for pain reduction in plantar fasciitis .
Generally the 2 main protocol followed is stretching of tight structures around it and then strengthening of muscles, ligaments and soft tissues for any futher damage.
Initially in first week, RICE protocol is followed along with ultrasound machine .
In electrotherapy , TENS (trans cutaneous electrical nerve stimulation)or IFT (Inter Ferential therapy ) can be used for pain reduction.
Here R stands for rest, I stands for icing , C stands for compression and E stands for elevation of that joint.
Ultrasound machine is mainly for the, increase in process of soft tissue healing.
Deep tissue friction massage can also be performed in plantar fasciitis .
Massage force has to be applied by the dominant hand 2 fingers across the facia fibers .
More of the treatment part?
Taping and more specific kinesiology taping is done on the ankle joint to hold the position in slight plantarflexion to reduce the pain .
To reduce the stiffness in muscles which are tight, Dynamic cupping can be performed initially and then static cupping can be performed .
Cups are generally the suction cups which sucks the stiff structures and hold it for minutes .
Its basic rule of cupping, is to loosen down the stiff structure and promotes great blood circulation around it .
Dry needling is a great solution to plantar fasciitis.
You can dry needle the stiff structures like the Tendon-Achilles and especially the trigger points or knots formed inside the muscle.
But the therapist needs to be experienced and certified in it.
Strengthening exercises like ankle raises and ankle eversion exercises are performed but in later strengthening exercises .
Later on Therapeutic bands are used to resist these ankle movements for increasing the muscles strength and endurance .
Thus preventing from any further damage.
Exercises to treat plantar fasciitis at home?
As mentioned above you can apply ice and take rest .
Ice massage is a good technique in which you should apply the ice pack against the fascia fibers.
You can take a napkin or cloth beneath the foot and hold it through your feet for 10 seconds and drop it.
You can take a soft sponge ball or a tennis ball and roll through your feet , for massage purpose. For atleast 15 seconds .
Do these exercises for 3 times in a single set.
Perform it 3 times in a whole day.
Advancements in Plantar fasciitis?
Orthotics sole comes nowadays that can be directly inserted inside the footwear.
So you do not have to change your footwear .
Apply these readymade sole orthotics.
Custom foot orthotics can also be made for individuals , but size and shape has to be taken before for proper measurement.
If by doing all these exercises and applying orthotics does not even cure 1 % of your plantar fasciitis , then surgery is only the last option for you. in plantar fasciitis.