Plantar fasciitis,overuse condition resulting in inflammation of plantar fascia

• Most common cause of foot pain in athletes. Occurs due to over use and stress on plantar fascia, which can result in tissue fatigue & micro tearing

• Causes plantar fasciitis
  Overuse, due to over training, poor technique, running on hard surfaces or prolonged standing, dancing or running
  Predisposing factors
  Poor biomechanics – excessive pronation, supination of the subtalar joint or excessive external rotation of the hip joint while walking
  Short & tight gastrocnemius & soleus muscles, which predispose foot to pronation
  Improper footwear that is worn out, too flexible, stiff or does not provide adequate arch support.
  Weight gain. Including pregnancy, which stresses the plantar fasciaSymptom picture plantar fasciitis

  Can be unilateral or bilateral

  Symptoms range from mild to severe. Pain has initial slow onset, with no history of injury or trauma

  Tension is placed on plantar fascia with repeated use & overtime is unable to repair itself & is partially torn away from calcaneus. After an initial period of acute inflammation, chronic inflammation sets in, accompanied by adhesions & fibrosing of the fascia. The plantar fascia thickens with chronic inflammation. Healing is slow as poorly vascularised

  Pain occurs with the first few steps after non weight bearing (getting out of bed in the morning). Symptoms are worse during pre swing phase of gait cycle an during stair climbing. Pain lessen with activity (30-45mins) then intensifies 2-3 hrs later with continued activity. Usually relieved by rest

  Pain Is usually located on antero-inferior surface of calcaneus on weight bearing. It may also extend along medial border of plantar fascia toeards meta tarsal heads

  Pes planus, cavus & Achilles tendonitis are often present. With repeated stress a bone spur may develop on medial aspect of calcaneusTreatment plantar fasciitis

  Acute

  Hydrotherapy is cold to affected area

  Reduce edema if present

  Reduce sympathetic nervous system firing & pain

  Treat compensating structures

  Chronic

  Hydrotherapy deep moist heat prior to stretch. Contrast after, increase local circulation

  Reduce sympathetic nervous system firing & pain

  Treat compensating structures

  Cross fibre frictions used within clients pain tolerance

  Mobilize hypomobile ankle joints

من و رئیس انجمن فیزیوتراپی ایران The head of Iranian physiotherapy association and I

من و خانم دکتر اما استوک رییس فدراسیون جهانی فیزیوتراپی Ms.Emma Stoke, the president of universal confedration of physiotherapy and I