Plantar fasciitis has a negative impact on the functionality and quality of life of people who suffer from it. In addition, the health and social repercussions are important, since it is estimated that 83% of patients with plantar fasciitis are of working age, which often leads to work disability with the social and economic cost that it represents.
What are the symptoms of plantar fasciitis?
In the initial stages, plantar fasciitis is characterized by:
- Pain
- Inflammation
- Decreased functionality
In the case that the fasciitis exceeds 6 months of evolution it is considered chronic fasciitis or fasciosis and the typical signs of fasciitis such as inflammation do not appear; what happens is a degeneration of the tissues.
Why does plantar fasciitis occur?
The causes of plantar fasciitis are poorly understood and its origin is usually multifactorial. The most widely accepted hypothesis is that plantar fasciitis is caused by overuse, i.e., excessive traction forces on the fascia.
Risk factors
Although the cause of plantar fasciitis is due to different factors, some risk factors to take into account are:
- Shortening of the triceps suralis (calf muscles). This is probably the most important risk factor and for this reason therapeutic protocols usually include stretching of these muscles and also of the plantar fascia.
- Obesity
- Excessive pronation of the foot
- Inadequate footwear
- Shortening of the ischiosural muscles (muscles of the posterior thigh).
- Decreased joint mobility in the metatarsophalangeal joint of the first toe.
- Repetitive microtrauma due to overuse.
- Rapidly increasing levels of physical, occupational, or athletic activity.
- Systemic pathologies, such as rheumatoid arthritis, ankylosing spondylitis, diabetes, low estrogen, and poor nutrition.
In the world of sports, the risk factors are:
- Excessive activity
- High intensity
- Soft training surfaces such as the tartan of athletic tracks
- Errors in sports technique
- Errors in training
- Fatigue
- Strength and flexibility deficits
Prevention of plantar fasciitis
The prevention of plantar fasciitis involves avoiding sudden increases in the intensity and duration of walking or running. All physical activity requires progression and an adaptation process.
It is also important to invest in good street, sports or work shoes. To control the feeding and the overweight. Maintain good elasticity of the muscles of the posterior thigh and calf region.
How is plantar fasciitis diagnosed?
Making the diagnosis of plantar fasciitis is quite clinical. The specialist in Physical Therapy will perform the following steps to make the diagnosis:
- Physical examination: it is common to provoke pain when pressing on the proximal insertion of the plantar fascia.
- Ultrasound: it allows to detect changes in the thickness and echogenicity of the fascia. It can also detect the presence of calcifications, bursitis or fascia ruptures.
Treatment of plantar fasciitis
Plantar fasciitis responds well to multiple conservative therapies, as with early diagnosis and timely application of traditional conservative treatments symptomatology resolves in 80% of cases.
Initial treatments are based on:
- Stretching exercises of the plantar fascia and calf muscles (gastrocnemius).
- Use of heel cushions and avoidance of low-heeled shoes.
- Anti-inflammatory drugs and corticosteroid infiltrations.
There is a percentage of patients (20%) who do not respond to conservative treatments and may be candidates for other treatments such as:
- Shock waves
- The surgical option