It has to be Plantar Fasciitis!
Plantar Fasciitis/Fasciosis is a common diagnosis that walks into my office. Either something that has been self-diagnosed (thank you Internet) or else from another provider. However, is this the correct diagnosis for those who have foot pain? We are going to dive into Plantar Fasciitis and conditions that present similarly.
Trojan et al, stated that roughly 10% of the population will be diagnosed with Plantar Fasciitis. Hamstring hypertonicity, pes planus (flat feet), limited ankle range of motion and increase in body mass are all risk factors for developing Plantar Fasciitis. Symptoms that patients may experience is an increase in foot pain after being inactive, walking up stairs, and foot pain the first couple steps in the morning. There should be no numbness and tingling due to not being a neurological complaint.
Typically it presents as calcaneal heel pain, that can get worse with increase in great toe extension. This is associated with the Windlass Mechanism. According to Wearing et. al, the plantar fascia acts like a pully system where tension is created on the bottom of the foot doing dorsiflexion of the great toe. Which means that anytime that the tension is applied to the big toe, there will be an increase in foot pain. It can be common for people to stop pushing off their big toe during gait due to the increase in pain and start pushing off on the 2nd or 3rd toe.
There are a number of conservative treatment options that are beneficial to try for plantar fasciitis. Working on the tissue on the bottom of the foot, whether it is through massage or instrument assisted soft tissued mobilization can reduce the pain on the bottom of the foot. Stretching the muscles along the back of the leg, hamstrings, gastrocnemius, soleus, have shown to be beneficial for reducing tension on the bottom of the foot. Strengthening & stretching of posterior tibialis, which is a muscle deep in the lower leg, has been beneficial in helping reduce foot pain long term. Performing ankle mobilizations & adjustments is a great way to improve range of motion. You can create more stability & support by adding in foot exercises to create a more stable base. It is all about finding ways to take tension off the foot while building strength and stability in the body. Seeking out the help of a healthcare provider can be beneficial to reduce pain if you are experiencing Plantar Fasciitis/Fasciosis pain.
Trojian T, Tucker AK. Plantar Fasciitis. Am Fam Physician. 2019 Jun 15;99(12):744-750. PMID: 31194492.
Wearing SC, Smeathers JE, Urry SR, Hennig EM, Hills AP. The pathomechanics of plantar fasciitis. Sports Med. 2006;36(7):585-611. doi: 10.2165/00007256-200636070-00004. PMID: 16796396.
