Plantar Fasciopathy and Heel Pain

Plantar fasciopathy is pain and inflammation located in the bottom of the heel. It arises due to changes to the collagen fibres, blood vessels, and the nerves in the tissue supporting the arch of your foot. Calcification is often present too and might be in the form of a heel spur. However, the presence of a heel spur does not always result in heel pain. 

Plantar fasciopathy is the overarching term for this foot condition and is a common cause of heel pain. One in ten people will suffer from it in their lifetime. Plantar fasciitis is the specific term for inflammation of the plantar fascia. Plantar fasciosis occurs when the tissue in the ligament breaks down. Both these conditions come under the category of plantar fasciopathy and symptoms for both can be quite severe. 

It is important that we get the terminology correct, because the way we treat tissue degradation is very different to inflammation. It is important to be given exercises and treatments to target the root cause of your pain. 

Risk factors for plantar fasciopathy includes:

• Repetitive loading from high impact activities such as sport
• Calf tightness
• Being overweight 
• Having a high arch 
• An increase in activity level

Understanding Plantar Fasciopathy and Heel Pain

The foot pain is experienced on initial weight-bearing activity, eases and then can be greater once the activity is ceased. It is often present first thing in the morning when getting out of bed and taking your first step.

The symptoms are often experienced in 2 stages. The first stage occurs at the beginning of the plantar fasciopathy and is a dominant pain stage. The pain is often worse early in the morning. Usually, you will notice reduced tolerance of your daily activities and sport that you usually could do. This stage is difficult to predict, but often lasts 6-8 weeks. 

The second stage is, in contrast, a load dominant stage. It is not often painful, and it is when the plantar fascia is ready to take loading to strengthen it. This is when it is important to see your physiotherapist to develop a specified exercise programme to treat the foot pain as effectively as possible. 

The way that plantar fasciopathy has been treated has changed significantly over the past 15 years. The research into the mechanical disturbance caused by plantar fasciotomy has evolved over the years, hence our understanding of how to treat it has, too. 

What we know about this condition is that seeking early treatment is important. The sooner physiotherapy treatment is sought, the better for you. If you wait months before treatment when experiencing these pains, the condition will have gotten much worse and may take a lot longer to resolve. Ignoring plantar fasciopathy may result in you changing the way you walk to relieve the foot pain. This may lead to other problems in the foot, knee, hip or back. 

This condition can take around 6 months to resolve. During this time it is very important to abstain from aggravating activities and manage the load you place on your plantar fascia. 

Physiotherapy Treatment for Plantar Fasciopathy Includes:

• Rest from aggravating activities (load modification)
• Ice (frozen water bottle rolling)
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Hands-on Physiotherapy treatment
• Physiotherapist prescribed exercises: calf stretches, plantar fascia stretches, foot intrinsic muscle strengthening, progressive loading activities
• Supportive Footwear with arch supports
• Heel Pads
• Dry Needling

Even if you do not suffer from plantar fasciopathy, preventative measures are always a good idea. Shock absorbing insoles can limit any excessive load on the foot, which reduces the chance of getting injured. Strengthening the foot through foot exercises and stretches also reduces the load, because it strengthens the muscles in the foot to protect the plantar fascia. 

Your physiotherapists at City Physiotherapy are experienced in the treatment of this painful foot condition and we have seen some excellent results in getting people back on track after having plantar fasciopathy.

To book an appointment, give our friendly receptionists a call on 8212 4886 or make an online booking today.

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