The plantar fascia is an aponeurotic covering located on the sole of the foot and that constitutes the separation between the subcutaneous cellular tissue and the plantar muscles of the foot.
It does not exactly consist of a muscle, although its thickness is similar to that of a tendon, being very thick and resistant, especially in its middle portion. The plantar fascia is divided into three differentiated fascicles, which due to their anatomical location are called: middle fascia, external fascia and internal fascia.
The plantar fascia originates from the plantar aspect of the calcaneus and inserts into the metatarsophalangeal joints in its middle portion, at the base of the fifth metatarsal in its lateral portion, and in the first metatarsal in its inner portion.
Its function is related to the transmission of forces from the Achilles tendon to the toes and is essential in the moments of taking the foot off the ground and in the impulses prior to the jump.
Plantar fasciitis is known as the inflammation of this aponeurotic tissue due to traction and repeated trauma that causes an increase in tension.
Plantar fasciitis is common in athletes of different specialties, being more normal to find it in athletes who perform repeated jumps or large impulses with the front of the foot, such as long or high jumpers, in basketball, volleyball, etc. In any case, it can occur in any athlete since it is also related to alterations in the shape and function of the foot.
Causes of plantar fasciitis
Plantar fasciitis is related to the increased traction forces that this tissue must withstand during walking and running. There are different situations that can favor the appearance of plantar fasciitis among which are
- Achilles tendon retraction.
- Cavo foot .
- Pronated or valgus feet with excavated footprints.
- Flat feet related to Achilles tendon shortening.
- Spasticity of the flexor muscles of the foot.
- Neuromuscular diseases.
- Foot muscle imbalance due to biomechanical alterations.
- Poor sports training or lack of warm-up when starting physical activity.
- Flat shoes without heels.
All the above circumstances converge in a common condition: increased tension in the sole of the foot, either due to muscular, biomechanical or structural alterations, or due to tensions transmitted by the Achilles tendon.
In short, the increased tension of the plantar fascia will generate an inflammation of the same, preferably located in the area of origin, that is, in the plantar area of the calcaneus bone. This inflammation will cause pain at this level, in the heel, but the pain is often radiating distally, towards the toes, and can be located in the area of the inner arch of the foot or in the middle area of the sole. .
Symptoms of plantar fasciitis
Plantar fasciitis is mainly painful. The pain is generally located in the posterior area of the sole of the foot, just at the origin of the fascia in the calcaneus bone.
The pain usually increases with pressure, in the phase of taking the foot off the ground and in stretching movements of the plantar fascia or the Achilles tendon.
Sometimes the pain can radiate distally to the toes and be located in the central area of the sole, preferably in the area of the inner arch of the foot.
If the fasciitis has been established for a long time, a swelling of variable size and depending on the degree of injury can be palpated.
The patient with plantar fasciitis has difficulty walking on his toes and experiences pain when jumping or running, because in these situations the tension is increased at the level of the plantar fascia.
Plantar fasciitis also causes pulling or cramping in the sole of the foot, especially after a walk or after exercising. They also tend to appear when wearing excessively flat shoes.
Plantar fasciitis is common in ladies who usually wear high-heeled shoes, and suddenly they wear flat shoes or sneakers. This circumstance causes plantar fasciitis to appear sometimes after having made a sporadic outing to the field or having casually worn sports shoes. The use of the high heel favors the shortening of the Achilles tendon and in this way the tension is considerably increased at this level when you want to walk without any elevation in the heel.
Plantar fasciitis commonly appears in athletes who perform sudden jumps or starts, producing a sharp pain in the sole of the foot that is usually located near the heel.
How is it diagnosed?
The diagnosis of plantar fasciitis begins with a correct clinical examination of the foot and a physical examination of the foot.
It is necessary to evaluate the degree of retraction of the Achilles tendon by assessing the range of dorsiflexion of the foot, which is normally diminished in these circumstances.
Radiological exploration is necessary to rule out the presence of other pathologies that produce similar symptoms, such as the calcaneal spur. Radiography is necessary to visualize the possibility of the presence of this calcaneal bone lesion.
Biomechanical analysis of the foot is essential. With this we can detect abnormal gestures that the foot develops during walking and that can favor the appearance of fasciitis.
The use of computerized plantar pressure analysis methods helps us in the diagnostic judgment. Normally in these feet there is increased pressure on the heel and on the ball of the foot.
If the diagnosis is complicated, ultrasound or nuclear magnetic resonance can be accessed to detect the inflammatory process more accurately.
Plantar fasciitis treatment
Treatment of plantar fasciitis involves several procedures. First of all it is necessary to treat the pain with analgesic therapy. For this we can use:
- Non-steroidal anti-inflammatory drugs.
- Infiltrations of corticosteroids and local anesthetics.
- Cryotherapy (in acute phases).
- Functional bandages.
Once the painful symptoms have been reduced, it is necessary to treat the increased tension in the plantar fascia. The relaxation mechanisms will depend on the cause that has caused the fasciitis, being able to use, among others:
- Massages and stretching.
- Use of orthopedic insoles that compensate for biomechanical and functional alterations that may exist.
- Rehabilitation of weakened muscles.
- Shoe modifications that relax the fascia of the foot, such as elevators or heels.
How can I avoid it?
To prevent the appearance of plantar fasciitis, it is advisable to follow the following tips:
- Do not wear excessively flat shoes. The normal thing is to wear 2-3 cm of heel to facilitate the normal function of the foot.
- Do not go from a high-heeled shoe to a flat shoe without progressive accommodation.
- If you are an athlete, always do stretching before starting the exercise.
- Do not practice physical exercise without a correct training plan.
- Wear suitable footwear if you plan to walk for a long time.
- Visit your Podiatrist if you have observed changes or deformities in your feet. If not, an annual review is advisable.
- Use orthopedic insoles prescribed by a professional if you suffer from a biomechanical or functional alteration of the foot.
You need to go to the Podiatrist if:
- You have frequently suffered from pain in the sole of your foot after a walk or after exercising.
- If you know that you suffer from an alteration in the foot such as flat foot, pes cavus, valgus foot, etc., so that a correct treatment of your deformity can be planned and to avoid the appearance of complications.
- If you notice cramps or pulling on the sole of your foot.
- If you experience pain when wearing a flat shoe or a sneaker.
Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.