How to relieve plantar fasciitis.
Plantar fasciitis (PF) is a common condition that causes debilitating pain to the tissues (fascia) on the underside of the foot, normally towards the heel. This tissue (the plantar fascia) is a thick band of tissue that supports the foot arch and helps in shock absorption during walking and running.
Plantar Fasciitis
Plantar fasciitis is typically at its worst after periods of rest, particularly first thing in the morning after getting out of bed. It can also flare up after long periods on your feet.
Although PF is traditionally thought of as an inflammatory condition (hence the ‘itis’ name) , more recent research has shown that it is more of a breakdown (degeneration) of the tissues under the foot. This breakdown is called ‘mucoid degeneration’, and leads to the tissues (fascia) on the underside of the foot becoming thicker, more calcified and mixed with gel-like materials.
Two separate types of patients tend to experience plantar fasciitis, athletes (runners) and older, less active adults. In the second group, being overweight (BMI 27+) or having diabetes are both significant risk factors.
What can you do to relieve your plantar fasciitis ?
In 2021 a scientific research paper thoroughly reviewed the different treatments for plantar fasciitis. Those treatments with a reasonable amount of evidence of success are shown below. Please note, the results were a bit more nuanced than I’ve shown, but I’m trying to keep it simple!
Lose weight
Strengthen your foot and calf muscles.
Improve your ankle and big toe mobility.
Wear orthotic insoles to support your foot arches.
Physical therapy (Massage/mobilisation/stretching).
Acupuncture.
Red light (Photobiomodulation) therapy.
As for medical interventions, the review also covered; Surgery, corticosteroid injections, platelet-rich plasma (PRP), prolotherapy and shockwave therapy (SWT) treatments. The research picture for these procedures was complicated and often contradictory, but overall PRP and SWT were described as safe and effective in the longer term. Anyone considering one of these procedures should take a look at the research paper for more details.
What can osteopathy offer?
In my experience plantar fasciitis responds well to osteopathy, but needs to be tackled on multiple fronts. My approach is usually to improve the mobility of the foot and ankle bones and also loosen the tissues under the foot with stretching and massage work. I will also work on stretching and loosening the calf, hamstring and gluteal muscles. I am also able to offer red light therapy (photobiomodulation) and acupuncture (dry needling) at my clinic.
Importantly, I always encourage my patients to carry out exercises at home to help with their problems. With plantar fasciitis, there are exercises to stretch, strengthen and massage the underneath of the foot. I’m also a fan of inexpensive off-the-shelf orthotics, which I’ve consistently found useful with patients.
If you would like to see what sort of exercises and orthotics I recommend for plantar fasciitis, then please follow this link to my exercises page.
If you are in the East Grinstead Area and have a plantar fasciitis problem then don’t suffer, book an appointment for your problem at Osteo Studio.
Cliff Russell, Registered Osteopath
Osteo Studio serving the areas of East Grinstead, Forest Row, Lingfield and the wider West Sussex area.
