Is that a rock in your shoe? Maybe not. It could be plantar fasciitis or heel spurs.

The plantar fascia is a thick, broad, inelastic band of fibrous tissue that courses along the bottom (plantar surface) of the foot. It is attached to the heel bone (calcaneus) and fans out to attach to the bottom of the metatarsal bones (long foot bones) in the region of the ball of the foot. Because the normal foot has an arch, this tight band of tissue (plantar fascia) is at the base of the arch. In this position, the plantar fascia acts like a bowstring to maintain the arch of the foot.
Plantar fasciitis is a self-limiting condition that is the most common cause of heel pain on the sole of the foot. It refers to an inflammation of the plantar fascia. The inflammation in the tissue is the result of some type of injury to the plantar fascia. Typically, plantar fasciitis results from repeated trauma to the tissue where it attaches to the calcaneus. This repeated trauma often results in microscopic tearing of the plantar fascia at or near the point of attachment of the tissue to the calcaneus. The result of the damage and inflammation is pain.

If there is significant injury to the plantar fascia, the inflammatory reaction of the heel bone may produce spike-like projections of new bone called heel spurs. The spurs are not the cause of the initial pain of plantar fasciitis, they are the result of the problem. Most heel spurs are painless. Occasionally, they are associated with pain and discomfort and require medical treatment or even surgical removal.
Pain on the bottom of the heel most prominent with the first steps taken in the morning is the most common presenting complaint of plantar fasciitis. Typical morning pain is caused by the foot resting in a pointed position (plantar flexion) during the night, allowing the fascia to contract. With the first steps of the day, the irritated fascia is stretched, resulting in pain. Pain also occurs with the onset of activity such as walking and running. It typically starts as a dull, intermittent pain in the heel and may progress to sharp, constant pain. This pain may decrease as activity progresses, but it usually returns after resting and then resuming activity. In severe cases, the pain may occur with any weight bearing. Although the pain usually occurs in the heel, it can radiate throughout the bottom of the foot toward the toes.
Plantar fasciitis is common in runners and dancers who use repetitive, maximal ankle and foot range of movement. It is also common in those who experience sudden weight gain and in overweight individuals who increase their activity level.

The condition is usually caused by a change or increase in activities, no arch support, lack of flexibility in the calf muscles, being overweight, a sudden injury, using shoes with little cushioning on hard surfaces, using shoes that do not easily bend under the ball of the foot, or spending too much time on the feet.

Factors that could be contributing are fallen arches or rolling in when running, age, poor shoes or support and a rapid increase in activity.

Consult your local PhysioPro to treat the problem. They will use ultrasound, deep tissue massage, prolonged stretching, and a specific exercise program to improve flexibility and elasticity of plantar fascia. Secondary to therapy, self-care is a vital component in the rehabilitation process. The use of non-steroidal anti-inflammatory medication (NSAIDS) e.g. voltaren, nurofen, aspirin, can help significantly to reduce the amount of irritation and inflammation in the plantar fascia. You will also get a home program which will include deep tissue massage, foot rolling with a golf ball or similar, stretching the calves and plantar fascia and avoidance of repeated impact and stress.


So get that rock out of your shoe and get into see the PhysioPro team today.

1 reply
  1. Kim OLeary
    Kim OLeary says:

    At Floreat, Wembley and Como Physio Pro clinics we see a lot of plantar fasciitis. Given that there is a high level of elderly residents in these established suburbs it is a problem that we see a lot. The common mistake people make is that they believe that their pain is coming from a heel spur however this is usually the end result of long term tension on the connective tissue on the underside of their feet (plantar fascia) due to poor footwear or biomechanics. The bodies response to long term traction is to spur out the bone which caused the spur however if managed better earlier the painful spur could be prevented to a degree. So it is initially the micro tearing and inflammation of the tendon which causes the pain and then long term the spur. At Oceanic Physiotherapy and Biotech Physiotherapy there are podiatrist on site to discuss prevention to couple with the Physio Pro teams manual therapy techniques.


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