Foot Pain: Plantar Fasciopathy
Plantar fascia pain and irritation is a common condition that is experienced by at least 10% of all people at some point in their lifetime. You may be someone who has had pain in your arch(es), the bottom of your foot, or your heel at some point. Often it is self-limiting, meaning that it resolves without intervention. However, for many people plantar fasciitis does become plantar fasciopathy, or even plantar fasciosis. Let’s clear up the verbiage.
Fasciopathy = disorder of the fascia
Fasciitis = inflammation, acute
Fasciosis = structural break down of fascia (long-term or chronic pain)
The term plantar fasciitis, when used appropriately, indicates inflammation of the plantar fascia due to acute tissue damage. What most people struggle with is plantar fasciosis, often a chronic experience of bottom of foot or heel pain caused by the plantar fascia having a loading intolerance. It requires both strengthening and lengthening to retrain it to function properly and to prevent the pain from returning.
This condition presents with sharp, painful initial steps in the morning or after sitting for long periods of time, often at the heel or bottom of the foot. It may improve during the day with activity but then become more painful again at night due to overuse. You may feel your foot or ankle is very stiff, with possible Achilles Tendon pain at the back of your ankle. While sitting, cross your leg so that your foot is resting on your lap. Push (gently to begin) where the arch of your foot meets your heel. It is very likely you have a tender spot here with plantar fascia irritation.
Exercises to try to alleviate pain and/or build strength in the bottom of the foot and lower leg include:
Passive toe extension (pulling toes up towards your face)
Standing calf stretch at the wall
Calf raises with toes on a towel
Ball roll out (side to side versus lengthwise)
Heel sitting with toes tucked for bottom of foot stretch
Another key component to all types of foot pain is footwear. Do you wear stiff, restrictive, or pointy shoes the majority of your day? Do you wear cushioned shoes with a thick sole or ones or with lots of arch support? These aspects of footwear that society tells us are good for us, actually limit the functionality of our feet and can lead to deconditioning and pain. Slowly increasing the amount of time you spend barefoot (at home, in the grass, etc.) will allow your toes to spread, your deep foot muscles to build resiliency, and even help to improve your balance. With plantar fascia irritation, it is important to slowly integrate more time barefoot, decrease the use of orthotics (if applicable), and wear footwear that is foot-shaped, as abrupt changes like these can cause increased symptoms if your body is already in an acutely or chronically painful state.
Have more questions about treating your plantar fascia pain and dysfunction? We would be happy to chat further about how Loon State Physical Therapy can be your teammate in getting you back to moving and feeling your best! Call us at (612) 405-8503 or book with us online at www.loonstatephysicaltherapy.com for an in-person or virtual appointment.
Bailey Van Oosbree, Doctor of Physical Therapy
Loon State Physical Therapy