The feet are made up of 26 bones and more than 33 joints which vary in stiffness. The level of flexibility in each joint allows for our gait to occur and the foot to move in response to the surface it touches.
What are fascia?
The middle of the foot is made up of five main bones which form the arch of the foot. Under this arch is the plantar fascia, sometimes known as the arch ligament.
Fascia is the connective fibrous tissue that holds our muscles and organs in place and our muscle fascia is responsible for springing our muscles back to their natural place. Plantar fasciitis is the inflammation of this tissue, and can be a significant cause of foot pain in both athletes and general public.
In response to excess stress, the plantar fascia can develop microtears which can cause inflammation of the fascia. Excess stress could be due to inappropriate training load or lack of strength around the calf, ankle and foot.
What are the signs and symptoms?Plantar fasciitis is characterised by localised pain on the arch of the foot. The pain with this condition is usually worse first thing in the morning when the tissue is at its stiffest. Pain usually decreases with exercise then increases after exercise, this is due to the tissue becoming warmer and more pliable with increasing movement.
Who is at risk?Risk factors for developing this condition include certain types of exercise; in particular exercise which places high forces and repeated stress through the Achilles tendon. Examples of this could be long distance running, or sports such as basketball where there is frequent running and jumping. This condition is most common in middle age but is not exclusive to this age group.
What is the recovery process?
Plantar fasciitis can generally be treated with conservative therapy. The use of anti-inflammatory medication may help this condition and also relative rest from aggravating activities.
Strengthening exercises need to be done to improve the mechanics of the foot and ankle, and strength work should focus around the calf complex.
Stretching the plantar fascia will also be helpful and this can be done by simply rolling a massage ball under the arch of the foot.
Stretching first thing in the morning and before exercise can go a long way to relieving this condition. As with any injury, the best way is to prevent the injury before it happens, so make sure you are doing regular calf strengthening work and not overloading your Achilles with excessive high volume training.