Inflammation of the plantar fascia, fasciitis plantaris
Foot plantar fasciitis (or plantar fasciitis) is one of the most common causes of foot and heel pain. Under the skin of the sole, a thick sheet of connective tissue (formerly called the plantar fascia) extends from the toes to the heel bone. Inflammation of this occurs mainly where it meets the bone, i.e. at the heel bone or at the base of the fingers. The first symptom is stabbing pain during the first steps in the morning. After a few steps it “settles”, but over time the pain becomes more prolonged. It is very difficult to “get rid of”. It can be treated at home, but be prepared for weeks, or even months, of regular treatment to get rid of it completely.
What is plantar fasciitis?
Fascia plantaris is a strong connective tissue sheet that extends from the heel to the top of the metatarsals (balls of the toes). It plays an important role in holding the plantar fascia in place. One of the main functions of the plantar fascia is to dampen the ‘impact vibration’ generated by the footfall. Its elasticity is the most important factor in this.
Symptoms of plantar fasciitis include a high degree of tenderness and pain in certain areas of the foot. It is most severe in the area of the heel sticking or at the base of the toes (or just one). The inflammation causes the fascia to thicken and become stiffer. This reduces its function and thus maintains the inflammation, which can become chronic. It can torment its “victim” for months or even longer.
Fasciitis is a consequence. It indicates that too much stress is being put on the plantar fascia, causing inflammation.
It is obvious that athletes do a lot of running and jumping and so the problem is particularly common among them.
It’s not just athletes who have this condition. It can occur in anyone when the plantar fascia is subjected to increased stress. All-day “foot-slapping” is also common among manual workers, teachers, waiters, and waitresses. They spend most of their working hours walking or standing on hard surfaces.
Obesity is a risk in itself. It increases the load on the plantar fascia, and therefore obesity is an increased risk. It can also be caused by inappropriately designed shoes, such as thin slippers worn all summer or barefoot walking.
Repeated exertion (running, kicking, kicking, ground catching, etc.) or uneven loading can cause micro-injuries to the connective tissue in healthy people. With constant strain, especially if stretching and recovery are neglected, they can easily become chronic.
Aim for a full recovery!
When treating a foot, focus not on the painful area, but on the cause of the overuse of the plantar fascia.
Replace shoes that are poorly supporting the foot. Reduce overweight and overloading. Relieve tension in the calf muscles.
Neglected and persistent inflammation can cause many micro-injuries and small tears in the fascia. Healing is accompanied by the formation of scar tissue, which has less elasticity so the original function cannot be fully restored. The more scar tissue, the greater the loss of function.
If the healing is partial, you cannot put your weight on your leg because of the pain. You will limp and this will start to put a bad load on other joints in your foot. Over time, your ankles, knees, hips, and spine will hurt too!
Inflammation of the plantar fascia can usually be cleared up in a few weeks or months. If you experience pain, start conservative treatment as soon as possible! Here are some ways you can help yourself to heal
Alternating hot and cold therapy
Place a bag filled with ice on the painful area for 10-15 minutes. Do not apply directly to the skin, as this may cause frostbite.
Cooling reduces inflammation and when you take the ice off, the body warms the cooled area, which leads to faster circulation. This in turn favours anti-inflammatory processes.
After 10-15 minutes of cooling, allow the muscles to warm up (1 hour off). Repeat 3-4 times. Overcooling is not good, i.e. don’t use this method for more than 2-3 days and don’t cool for more than 15 minutes at a time.
Another method is to fill a half-litre mineral water bottle with water and freeze it. Sit down on a chair, place the ice-cold bottle on the floor in front of you and step on it with your sore feet. Roll it backward and forwards. Massage the soles of your feet while cooling them thoroughly too. Do not put your full body weight on it, as it is not meant to cause pain, but to stretch, relax and cool the fascia. Do this exercise for 2 to 5 minutes maximum.
Reduce the load
Break up your workouts with running, jumping movements (but you are allowed to swim or even cycle). If you do exercise, take great care to relax after your workout. Take particular care to relax your calf muscles. Also, use a roller.
Replace your trampled work shoes with low-heeled ones that support the arch and dampen vibration. Put a silicone insert under the heel of your shoe to “cushion” the sore spot. Do not wear high heels. Do not walk barefoot, especially on hard surfaces, even indoors.
Replace worn, trampled sneakers. Running shoes should be replaced after about 600-800 km of use.
Overloading due to excess weight can in itself trigger inflammation of the plantar fascia. Maintain or restore a healthy weight.
Blow and massage
Sit on the ground. Stretch your sore feet. Put a belt or long ribbon over the top of your foot and slowly pull the toes towards you. Repeat 10-15 times. You can do it 3-4 times a day. This stretches the plantar fascia, which is stiff due to inflammation.
Sitting upright, hold your sore foot in both palms, and massage the sore area with your thumbs. You don’t need to apply a lot of pressure, the aim of the massage is to stimulate blood circulation. This will have a healing effect. Massage is also enough for 2-3x 5 minutes a day.
Inflammation is a physiological reaction with the aim of healing. However, if it is prolonged and persists for a long time, it already limits cellular function, stops energy production, does not produce enough protein, etc. for regeneration.
The first step in the case of inflammation of the gastrocnemius is to reduce the symptoms of inflammation.
This is not easy, as you are constantly putting weight on your foot with every step you take, so you are working against the healing process.
An additional problem is that the blood supply to the ligaments and tendons is poorer than to other tissues.
Physiotherapy methods that increase blood circulation to the foot speed healing.
Stimulating circulation first and foremost
Good circulation is the key to healing inflammation – it’s what will carry away the decomposition products and bring the healing substances to the area. The more methods you combine, the more they support each other and speed up healing.
Treat with therapeutic ultrasound
Use a therapeutic ultrasound device with a frequency of 1Mhz. Ultrasound has excellent anti-inflammatory properties. It warms up the treated tissues, relaxes stiff ligaments. It accelerates blood circulation and thus elimination of inflammation.
For example, the M-Sonic 950 or Sonostim 1032 therapeutic ultrasound is suitable for this purpose. One treatment a day is enough. Use low intensity (because the plantar fascia is close to the surface). Treat for 5-8 minutes over the painful area. Always use ultrasound gel and move the treatment head slowly and continuously. Continue to treat until the pain is gone and the area is completely healed.
Using an electrical muscle stimulator device can stimulate your healing indirectly by improving blood circulation. Use a muscle stimulator!
Treat the affected side calf muscles with capillarisation, warm-up, or muscle stiffness release programs. Muscle stimulation has been shown to increase blood flow to the treated muscle by up to 300%. In other words, the improvement in circulation in the leg will have a beneficial effect on the nearby area, including the plantar fascia. You can apply the treatment at least once a day, but up to several times.
Microcurrent is still a less common electrotherapy method today. It is one of the most effective pains and anti-inflammatory methods you can use at home.
Treat the painful area with electrodes around it 2-3 times a day for 20 minutes each time.
Apply light therapy!
Soft laser treatment has an anti-inflammatory effect similar to microcurrent. It is even easier to use than electrical treatment.
You hold the device on the painful spot and hold it there while the laser beam delivers the therapeutic amount of energy. The time required for the treatment is indicated in the instructions for use, but it usually takes 5-10 minutes to treat the Achilles. The higher power soft laser delivers the required energy in a shorter time.
For example, the Personal Laser L400 or the Energy-Laser L500 Pro is suitable. Soft laser devices can be found here.
If these practices don’t help, clinical physiotherapy (shockwave therapy, irradiation) is another option.
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