How to get rid of Plantar Fasciitis, the foot of all evil

Plantar Fasciitis is often a dreaded foot disease - but with persistent and consistent treatment it can be overcome! Mok Ying Rong - UFIT Clinic physiotherapist,  Nike Sponsored elite athlete, Singapore’s Half-Marathon record holder and winner of the 2017 Great Eastern Womens' Half Marathon - shares her advice on overcoming Plantar Fasciitis right here ... 

Plantar_Fasciitis_Injury.jpg

What is plantar fasciitis?

It is a clinical condition characterised by sharp pain in the middle of the heel and along the arch area. Pain is often worse with the initial few steps after prolonged inactivity such as the first step you take in the morning. Pain gets better with some movement but increases with further loading. Pain is often worse at the end of the day.

Who gets it?

Athletes who engage in repetitive weight-bearing sports such as distance running, basketball. Weekend warriors who engage in a sudden increase in sports coming from a level of sedentary desk work throughout the week. There is also some evidence linking ageing with plantar fasciitis. People with occupations requiring prolonged standing and walking.

What contributes to the development of plantar fasciitis?

Intrinsic and extrinsic factors both play a contributing role. Intrinsic factors include arch height, hypomobility of the ankle, tight calf muscles etc. Extrinsic factors consist of factors such as inappropriate footwear, uneven ground surfaces, increased in weight-bearing activities, sudden increased in mileage and increased Body Mass Index. Alteration of ankle-foot biomechanics resulting from previous injuries and soft tissue or joint limitation can contribute to the development of PF. For example, tight calves can limit the mobility of the ankle which can subsequently result in excessive compensatory pronation, leading to a strain at the plantar fascia.

How does physiotherapy help plantar fasciitis?

Plantar_Fasciitis_stretch.jpg

Your physiotherapist will help to manage and reduce your symptoms by utilising a variety of techniques according to your specific needs. Techniques include joint mobilisation, soft tissue releases, gait and footwear analysis. If you engage in sports such as distance running, your physiotherapist may also discuss with you on appropriate progressing of training loads. The physio will also assess for other factors that can put you at risk of symptom recurrence. Throughout the whole process, you will also need to play a part by doing the exercises that your physiotherapist will teach you.

If necessary, you will be prescribed orthotics and night splints. Orthotics can help to minimise excessive pronation which causes additional strain to the plantar fascia. Wearing a night splint at night allows the fascia to be placed in a more optimal and relaxed position.

Running and plantar fasciitis

Plantar fasciitis can be very persisting which gets increasingly difficult to treat the longer it is present. The best way to go about it is to prevent it. Try running on soft surfaces, increase your running mileage by no more than 10% per week, perform regular stretches for your calves after each run and wear the proper shoes for your foot type and gait.

Here are 3 activities to try out :

1. Assess the flexibility of your big toe

Can your big toe be raised up to an angle of 50 degrees when your knee is positioned above your foot (as in the diagram)? The flexibility of the big toe allows the ‘windlass mechanism’ to occur. This windlass mechanism is the winding of the plantar fascia to elevate the medial longitudinal arch. Without this mechanism, the foot loses its stability and the foot’s stability muscles cannot function well. The plantar fascia is then subjected to great amounts of strain.

2.    Stretch your calves

Here are two variations of calf stretches. For both variations, you can alternate between doing it with a straight knee and a bent knee. The former focuses on stretching of the gastrocnemius while the latter focuses on the soleus (the deeper of the two calf muscles).

a. Wall stretches

wall_stretch.jpg

b. Hang off an edge

hang_off_an_edge.jpg
Hang_off_edge.jpg

c. Self-mobilisation of the plantar fascia

With one hand, pull the toes of the foot back to place the fascia on a stretch. With the other hand, massage the fascia by applying gentle but firm pressure across the fascia along the arch. Do this for 5-10minutes, 2 times a day.

Plantar Fasciitis Stretch.jpg

About The Author

Mok Ying Rong.jpg

Ying is a physiotherapist with an intense passion in the musculoskeletal field. She utilises a holistic manual approach alongside an energetic desire to get people back to a pain-free status. Ying started off her career as a physiotherapist in the private sector. During her period here, she found her niche in analysing and treating issues related to the running biomechanics. 

Ying is also an avid sportswoman. Ying started off as a competitive swimmer before transiting towards triathlons and finally establishing herself in the running domain. Her more memorable achievements include breaking the Singapore National Half-Marathon record in the 2016 Gyeongju Half Marathon and representing the nation in the 2015 World Cross Country. Ying's first hand sporting experiences allows her to relate better to people who are passionate about sports.

QUALIFICATIONS

  • BsC Physiotherapy (Queen Margaret University)
  • Dip Physiotherapy (Nanyang Polytechnic)
  • National Coaching Accreditation Programme (NCAP) theory level 1