Plantar fasciitis is one of the most common causes of persistent heel pain. It develops when the plantar fascia, a thick band of connective tissue running along the bottom of the foot, becomes irritated or inflamed. This tissue is essential for supporting the arch of the foot and absorbing shock during activities like walking, running, or standing.
Pain and stiffness associated with plantar fasciitis is felt near the heel with symptoms typically worsening with prolonged activity or after periods of rest, such as overnight sleep.
Plantar fasciitis is often considered an overuse injury however there are often multiple contributing factors leading to the onset including, poor footwear, biomechanical dysfunctions, systemic issues like inflammation or hormonal changes, and lifestyle habits.
Understanding these interconnected causes is key to effectively managing and preventing plantar fasciitis.
Causes of plantar fasciitis:
Foot Mechanics and Modern Footwear:
The feet serve as the foundation of the body, designed to absorb shock, support weight, and adapt to the various surfaces we walk on. However, modern footwear – often rigid, overly cushioned, or ill-fitting – can disrupt these natural functions. Prolonged use of such shoes can limit the natural movement of the feet, leading to weakening of the small intrinsic muscles. This weakened foundation can alter the biomechanics of the foot, placing increased strain on the plantar fascia, increasing susceptibility to injury or irritation over time.
Hip and Lower Limb Biomechanics:
The way the pelvis, hips, knees, and ankles move directly influence how load is distributed through the feet. When there is tightness or weakness in any of these areas, the body often compensates, which can alter gait patterns and increase stress on the plantar fascia. For example, limited mobility in the hips or tight calf muscles may shift weight unevenly across the foot. Over time, these compensations can contribute to irritation and pain in the heel.
Systemic Inflammation
Increased inflammation throughout the body can arise from various factors, including chronic health conditions, increased body weight, stress, and diet. This persistent low-grade inflammation can disrupt the body’s natural healing processes, exacerbating tissue irritation, prolonging recovery, and increasing the risk of recurring pain.
Hormonal Influences
Hormones play a crucial role in maintaining tissue health. Fluctuations in estrogen levels, such as those occurring during perimenopause, can reduce collagen elasticity, making connective tissues like the plantar fascia more vulnerable to injury. Estrogen also anti- inflammatory properties, and declining levels can contribute to increased pain and inflammation throughout the body. These hormonal changes may help to explain why plantar fasciitis is most commonly experienced in woman aged 40-60. Understanding the impact of hormonal shifts allows treatments to be more effectively tailored to individual needs.
How Osteopathy Can Help
Osteopathy adopts a whole-body approach to assessing and managing plantar fasciitis, combining hands-on treatment with practical advice to address the root causes of the condition. Key components of osteopathic care include:
1. Biomechanical Assessment
A comprehensive evaluation of body movement helps identify areas of strain or dysfunction contributing to plantar fasciitis.
2. Hands-On Treatment
Techniques such as soft tissue massage, joint mobilisation, and myofascial release are used to reduce tension in the foot and associated structures.
3. Exercise Prescription
Targeted exercises, tailored to the individual by a qualified professional, are essential for supporting recovery and reducing the risk of recurrence. These exercises aim to improve strength, flexibility, and overall biomechanics of the foot and lower limb.
4. Lifestyle and Footwear Advice
Guidance is provided on selecting footwear that supports natural foot mechanics and incorporating strategies to minimise strain on the plantar fascia during daily activities.
5. Addressing Systemic Factors
Treatment considers how diet, stress, and overall health might influence recovery, with strategies offered to support systemic healing.
Final Thoughts
Plantar fasciitis is a multifaceted condition that extends beyond the foot. By addressing the interplay of biomechanics, systemic health, and lifestyle factors, osteopathic care provides a comprehensive and tailored approach to managing this condition.
For those seeking relief from heel pain, osteopathy offers a path to addressing the rootcauses and promoting overall wellbeing—not just healthier feet.
By Emma Winn - Registered Osteopath
