Plantar Fasciitis

Four Phases of Plantar Fasciitis/Heel Spur Rehabilitation

In Conditions by Alnoor Ladhani, Chiropodist

Plantar fasciitis is condition which occurs when the plantar fascia ligament, which runs from the heel bone to the toes, develops micro-tears or becomes inflamed. Sufferers will experience pain, inflammation, tightness in the heel area, or signs of scarring. The condition is the most common type of foot and heel pain; however, it is treatable. There are 4 phases involved in the treatment of plantar fasciitis, which will first relieve pain and then reverse the condition.

Phase 1 – Pain Management

Plantar fasciitis makes walking normally extremely difficult for the sufferer. The resulting pain causes the sufferer to arch their heel when walking, which further aggravates the condition. In order to prevent further damage, it is important to first provide pain relief. If the condition is diagnosed as being caused by any particular activities, the patient should avoid those activities until the condition is reversed. Ice is an effective form of pain relief, which also reduces swelling and inflammation. Applying ice (every two hours if pain is excessive and every four hours for milder pain) will provide significant pain relief.

Phase 2 – Manage Inflammation

In more severe cases of plantar fasciitis, the sufferer will need to take anti-inflammatory medication along with treating the condition with ice. The sufferer can also reduce inflammation by freezing a bottle of water, which can then be used to cool and massage the inflamed areas. A frozen golf or similar sized ball is also good for focusing on specific areas of inflammation. Roll the ball around affected area for periods of up to thirty seconds, before moving onto the next area. These cold treatment measures will reduce pain, inflammation, and help speed up recovery times.

Phase 3 – Repair damaged tissue, build strength and balance

It is important to ensure that the sufferer does not further damage the plantar fascia, if the treatment is to be successful. Protecting the foot will aid the patient’s recovery, allowing them to heal and build up strength. While the scar is healing, the patient must follow a regimen which ensures that the ligaments reform correctly. Massage, frequent light exercise, and gently stretching the toes and heel will allow the plantar fascia to reform in the correct way. Further consideration also needs to be given to any stiffness in the foot or other joints, which may have contributed to the cause of the condition. By resolving issues with stiff ankle joints, for example, the likelihood of plantar fasciitis recurring is greatly reduced.

Phase 4- Follow up and maintenance for long term success

As Plantar fasciitis is extremely common, patients run the risk of repeat injury. This is especially true for athletes involved in sports such as soccer, football, baseball, running etc. The therapist should discuss goals with the patient, which they will then review periodically to ensure the patient’s normal foot biomechanics have been restored. Athletes may need more frequent assessments, where proper running, landing, and turning techniques can be discussed to help avoid a recurrence of plantar fasciitis. Follow up sessions are recommended to give the patient the best possible chance of recovery, and to increase the likelihood of long term success.

If the four phases are carried out correctly, taking into account the cause of the patient’s plantar fasciitis, the patient has around a 90% chance of full recovery and restoration of normal movement. However, it is essential that the patient is provided with a detailed treatment plan, so that recovery is as quick and effective as possible. Athletes will also need to continue recommended exercises, once they have returned to active competition.