Plantar Fasciopathy (aka Plantar Fasciitis)

Plantar fasciopathy (formerly “plantar fasciitis”) is quite a common condition and I see this in the clinic more frequently than I previously used to. It's hard to say whether it is diagnosed more accurately these days, or its incidence is actually increasing! 

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Essentially the fascia of the plantar surface (under side) of the foot becomes painful, commonly at the calcaneal (heel bone) insertion, or the arch of the foot. Usually it involves morning pain where it can be almost impossible to bear weight for 5-30mins, and pain with walking longer periods or on harder surfaces. 

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The wider literature suggests plantar fasciopathy is caused by:

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Increasing your BMI faster than your body (or foot) can tolerate  

More body weight = greater compressive and tensile loads through the plantar fascia with each step. Their everyday loads can be quite high, and therefore only small increases in activity levels can result in large increases in foot loading pressure (van Leeuwen, 2016). Staying at a high body weight can reduce the threshold for developing it too. 

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High loading rate (relatively fast increase in loading)

Similar to the above point, this is essentially when someone increases their body weight or increases their activity levels significantly and quickly. Essentially it is "unaccustomed activity". Examples are during some pregnancies, novice runners (especially if they have just decided to “get fit” without a structured approach), and heavy scheduling of sporting commitments (too many events in a short space of time) (Rathleff, 2015). Addressing these factors will be part of the solution.

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Specific foot muscle weakness

Specific intrinsic muscles of the foot are responsible for attenuating forces (distributing and absorbing weight) sustained during various types of physical activity including walking. They help keep the shape of the foot’s  arch. Weakness of these foot muscles contribute to the development of plantar fasciopathy (Huffer, 2017). Strengthening these muscles is important to a successful outcome, and reducing risk of recurrence (or prevention). 

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If you already have plantar fasciopathy, try

 

1. Calf stretches eg dropping a heel off a step 

2. Calf and foot strengthening exercises eg heel rises 

3. Changing your footwear, eg. a softer and higher heel can help.

 

Feel free to Contact Us for a more in-depth assessment of your problem.