What is Plantar Fasciitis?

 

Plantar fasciitis is an  inflammation of the long, thin ligament that lies directly beneath the skin on the bottom of your foot known as plantar fascia. The plantar fascia is a thick band of fibrous connective tissue spanning the arch from the posterior tuberosity of the calcaneus to the bases of the proximal phalanges. Histologically, the plantar fascia bears resemblance to both tendon and ligament with a relatively inelastic extracellular matrix composed of collagen fibres in a wavy or crimped pattern, produced by elongated fibrocytes embedded in longitudinal rows. 

 

Benphysio does provide this service in all our outlets in Oval Damansara, Bangsar, Puchong, KL Ampang, Cheras and Giza KD. We specialized in hands-on physiotherapy to treat the problem.

 

Etiology 

 

1. Abnormal foot posture

Posisi kaki yang tidak normal

• Flat foot may lead to prolonged stretching of the plantar fascia due to loss of the foot arch, resulting in further damage to the plantar fascia. On the other hand, in patients who have high arched foot posture, the plantar fascia may be damaged owing to poor shock absorption by reduced ground contact area.

Kaki rata boleh menyebabkan peregangan berpanjangan pada plantar fascia disebabkan oleh kehilangan lengkungan kaki, yang mengakibatkan kerosakan lebih lanjut pada plantar fascia. Di sisi lain, pada pesakit yang memiliki posisi kaki berlengkung tinggi, plantar fascia boleh rosak disebabkan oleh penyerapan hentaman yang lemah akibat kawasan sentuhan tanah yang berkurangan.

 

2. Weakness of the calf muscles

 

• Weakness in the peroneus longus and brevis muscles, flexor hallucis longus and brevis, and tibialis posterior all contribute to decreased ability to lift the foot in gait and increased tension on the plantar fascia.

 

3. Tightness of the calf muscles

 

• Evaluation of the range of movement (ROM) may reveal a restricted ROM of the ankle dorsiflexion, indicating that there is tightness of the gastrocnemius or Achilles tendon or dorsiflexors.

 

Symptoms

 

Typically, patients report a dull aching or throbbing pain, which is localised to the area around the origin of the plantar fascia on the calcaneus. This pain is usually worse with the first step in the morning. It often gets better with activity, but then worsens as the activity becomes prolonged or late in the day after hours of ambulation and weight-bearing activities.

 

 

Physical assessment 

 

1. Standing alignment and gait.

 

• Particular attention should be paid to the alignment of the hindfoot and the midfoot as individuals with pes planus or pes cavus are predisposed to the development of plantar fasciitis.

 

2. Palpation.

 

• The plantar fascia and its origin at the calcaneus should be palpated, to elicit tenderness.

 

3. Windlass test.

 

• This adds tension to the plantar fascia and locks the bones of the longitudinal arch to create a rigid beam for the support of full body weight in propulsion. However, individuals with pes planus, or flat foot type, overpronate, this will  increase stress on the plantar fascia and induce inflammation.

 

Physiotherapy Management 

 

1. Manual therapy

 

• Therapists can use manual therapy, consisting of joint and soft tissue mobilisation to the tight muscles as well as the plantar fascia, in order to improve lower extremity flexibility, decrease pain and improve function.

                                                                                        

2. Calf stretching

 

• Stretching exercises are not only an effective treatment strategy for plantar fasciitis but also the safest and therefore, should always be the first-line treatment. Stretching of the gastrocnemius muscle can be either self-directed or guided by a physical therapist. Stretching of the plantar fascia also plays a crucial role and has been shown, by itself, to be effective. 

 

We understand how back pain, neck pain, shoulder pain, knee pain, arthritis, or sports injuries like tennis elbow, golfer's elbow, and hamstring strains can take a toll on your life. These pains can make even the simplest daily activities feel like a struggle and rob you of the joy in your favorite hobbies. At Benphysio, we’re dedicated to changing that.

Imagine living without constant pain. Imagine getting back to the things you love without hesitation. Our expert physiotherapists at Benphysio combine manual therapy, exercise, and education to address the root causes of your pain and prevent it from coming back.

Again, we at Benphysio do provide this service in all our outlets in Oval Damansara, Bangsar, Puchong, KL Ampang, Cheras and Giza KD. We specialized in hands-on physiotherapy to treat the problem. Feel free to call us to make an appointment to get your problem diagnosed by our physiotherapists and fixed via hands on physiotherapy. We are available at Oval Damansara, Bangsar, Puchong, KL Ampang, Cheras and Giza KD.

 

Created by: Izzati (KL)

 

References

 

Latt, L.D., Jaffe, D.E., Tang, Y. and Taljanovic, M.S., 2020. Evaluation and treatment of chronic plantar fasciitis. Foot & ankle orthopaedics, 5(1), p.2473011419896763.

 

Motley, T., 2021. Plantar fasciitis/fasciosis. Clinics in podiatric medicine and surgery, 38(2), pp.193-200.

 

Lee, J.H., Shin, K.H., Jung, T.S. and Jang, W.Y., 2022. Lower extremity muscle performance and foot pressure in patients who have plantar fasciitis with and without flat foot posture. International Journal of Environmental Research and Public Health, 20(1), p.87.

 

Siriphorn, A. and Eksakulkla, S., 2020. Calf stretching and plantar fascia-specific stretching for plantar fasciitis: A systematic review and meta-analysis. Journal of bodywork and movement therapies, 24(4), pp.222-232.

 

Rabadi, D., Seo, S., Wong, B., Chung, D., Rai, V. and Agrawal, D.K., 2022. Immunopathogenesis, early Detection, current therapies and prevention of plantar Fasciitis: A concise review. International immunopharmacology, 110, p.109023.

 

Pearce, C.J., Seow, D. and Lau, B.P., 2021. Correlation between gastrocnemius tightness and heel pain severity in plantar fasciitis. Foot & Ankle International, 42(1), pp.76-82.

 

Lee, S.H., Suh, D.H., Kim, H.J., Jang, W.Y., Park, Y.H., Sung, H.J. and Choi, G.W., 2021. Association of ankle dorsiflexion with plantar fasciitis. The Journal of Foot and Ankle Surgery, 60(4), pp.733-737.

 

Stachelski, R.A., Torrilhas, B., Camboin, F.F., de Lima, D.F., Donin, C.B., Flor Bertolini, G.R. and Buzanello, M.R., 2024. Therapeutic Exercise in Plantar Fasciitis: A Systematic Review with Meta-Analysis. Muscles, Ligaments and Tendons Journal, 14(1), pp.29-45.

 

Yildiz, S., Sumer, E., Zengin, H.Y. and Bek, N., 2022. Intensive physiotherapy versus home-based exercise and custom-made orthotic insoles in patients with plantar fasciitis: Pilot study. The Foot, 51, p.101906.

 

Boonchum, H., Bovonsunthonchai, S., Sinsurin, K. and Kunanusornchai, W., 2020. Effect of a home-based stretching exercise on multi-segmental foot motion and clinical outcomes in patients with plantar fasciitis. Journal of Musculoskeletal & Neuronal Interactions, 20(3), p.411.

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📍 C-11-G, Sunway Giza Mall, Dataran Sunway, Kota Damansara

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