Did you know the most common cause of rearfoot pain is Plantar Fasciopathy/Fasciitis? This injury mainly occurs in runners and older adults and can often be associated with a biomechanical abnormality such as pronation or supination of the foot. The plantar fascia itself is the flat thick band of tissue that runs along the bottom of the foot. It is a collection of fibrous tissue running from the calcaneus (heel) to the toes. The pain typically presents as heel pain or pain on the bottom of your foot, specifically in the arch. The plantar fascia is responsible for supporting the foot and acts as a spring during walking and running.
Some of the most common risk factors have to do with increases in mechanical load, increases in training volume having to do with repetitive striking on a hard surface (running), prolonged standing on hard surfaces, imbalances in muscular strength of the calf muscles as well as decreased flexibility of the ankle joint and hamstrings.
Typically the pain is the worst in the morning and with the first few steps of the day. The pain can increase throughout the day as well with increased time being spent on the feet.
Treatment can be done preventatively as well as done to improve symptoms being currently experienced. Pain and discomfort should not drastically increase with treatment/exercises, however a mild increase in symptoms can occur and last for up to 24 hours.
Example Treatment:
1) Plantar release with ball – For 3 mins
- Place a hard ball under the arch of your foot and roll the ball around. Avoid rolling the ball directly on the heel.
2) Towel scrunches – For 2 mins
- Place a towel on the ground and curl your toes to scrunch the towel. This muscle targets the intrinsic muscles of the foot.
3) Gastroc/soleous stretch (Calf stretch) – 3 x 30 Second Holds
- Complete a calf stretch with both a straight and bent knee in order to target the two different muscles of your calf. Try standing in a lunge position keeping your back foot heel on the ground and lunge forward. Straight knee (Gastrocnemius) Bent knee (Soleus).
4) Plantar foot stretch – 3 x 30 Second Holds
- Sitting down, cross your ankle over your knee to support your leg and stretch your toes backwards. You should feel a stretching sensation along the bottom of your foot.
5) Low-Dye taping
- This taping technique can be beneficial for reducing strain in the tissues on the soles of the feet. It is used to offload structures and provide medial ankle support.
Jessica Leduc
Physiotherapist at Pivotal Physiotherapy
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References: Brukner, P., Khan, K., & Brukner, P. (2012). Brukner & Khan’s clinical sports medicine. Sydney: McGraw-Hill.