Plantar Fascitis – Causes and treatment
Plantar fascia is a thick, tense fibrous tissue located at the feet plant. It is inserted in the heel bone and extends forward to anchor to the base of the toes, covering the musculature of the feet plant. Inflammation of the fascia gives way to the injury known as plantar fasciitis. This injury manifests itself with a piercing, acute pain, when we walk and also when we palpate the feet plant. This pain is even more intense when, after a long period of inactivity, we start marching again. This is an injury that affect in greater measure to sportspersons who include running in their training programs.
Anatomical: Over pronation, flat feet, hollow feet, dysmetria of lower limbs, tendon-muscular shortening of the triceps surae. Conditions of sporting practice: Running over hard surfaces and/or use of inadequate trainers. Deficient running technique: Incorrect footstriking.
During the most acute phase of the injury our main objective is to bring down the inflammation. To do this, we will follow the procedure below:
1. Cryotherapy: Application of ice while at the same time doing a soft massage of the entire plantar surface, during a period of 10 to 20 minutes, three to four times per day.
2. Massage: We perform massage doing sliding, circular movements all along the base of the foot in order to reduce myofascial tension. The pressure to be applied and duration of the massage will depend on the tissues’ reaction and the degree of tolerance [to pain] of the individual. On average, we will do a daily massage. Its duration will be somewhere between five to ten minutes. We can also use a semi-hard rubber ball.
3. Orthopaedics: It is recommended the use of insoles in order to cushion impacts and correct possible structural flaws of the feet.
4. Stretching exercises: We will do stretching exercises of the plantar fascia and of the leg muscles, in order to elongate tissues and relieve passive tension over the Achilles Heel and the myofascial structure of the foot plant. These exercises will be done on a daily basis. We will do three stretching exercises of about 30 to 45 seconds, with the corresponding pauses.
5. Strengthening Exercises. When the inflammation has subsided, we can begin the muscular strengthening phase with an exercise that will require the patient to stretch and flex its ankle joints. The stretching range of movement trajectory must be done within tolerable limits of pain. The patient should do the effort without feeling its plants overcharged. There will we two weekly sessions with four or five series of 12-14 repetitions per series, with pauses of 60 seconds in between.