Plantar fasciopathy (fasciitis) and exercise EP 1

Plantar fasciopathy

Plantar fasciopathy as a chronic overuse injury – What is it and can it be rehabilitated?

Plantar fasciopathy is a chronic overuse injury that can be very painful and cause disruption to everyday life of sufferers. Chronic overuse injuries can occur at multiple locations in our bodies but as podiatrists we regularly see the plantar fascia affected. Irritation of the attachment of the plantar fascia (the enthesis) onto the heel bone (calcaneus) can be labelled as plantar fasciitis, plantar fasiopathy, heel spur syndrome or plantar heel pain syndrome.

Plantar fasciopathy is a relatively common condition and affects approximately 7% of people at some point in their life, having a slightly higher incidence in athletes. Often there will be thickening of the plantar fascia under ultrasound examination, pain after a period of rest and a consistent underlying ‘stone bruise’ like feeling.

Causes and treatment

A chronic overuse injury is an injury that occurs slowly over a period of time as opposed to an acute injury that typically occurs from a one-off incident. The development of an overuse injury can be thought of as a set of scales with work or tissue loading on one side, and capacity or tissue tolerance on the other side.  If there is too great an imbalance between the two sides for an extended period, the tissue may become degenerative and sensitive. New growth may be less organised and this is part of the reason degenerative tendons or fascias may appear thicker than expected on imaging.

Treatment can be aimed at either side of the above scales, with pathways that aim to reduce load on the irritated plantar fascia, or pathways that aim to improve the tissue tolerance of the fascia. A strength-based rehabilitation program is a tool aimed at increasing the tolerance of the fascia. 

For more information on strength based rehabilitation of your heel pain, stay tuned for our upcoming blog post on the issue or call now to make an appointment with one our podiatrists, Peter Foley or Catherine James.

If you would like to learn more about Plantar fasciopathy or faciitis, please call Spine Sport Feet clinic on 5580 5655 or click the contact button.

Luffy L, Grosel J, Thomas R, So E. Plantar fasciitis: A review of treatments. JAAPA. 2018 Jan;31(1):20-24. doi: 10.1097/01.JAA.0000527695.76041.99. PMID: 29227320.

Cardoso TB, Pizzari T, Kinsella R, Hope D, Cook JL. Current trends in tendinopathy management. Best Pract Res Clin Rheumatol. 2019;33(1):122-140. doi:10.1016/j.berh.2019.02.001
Rio E, Mayes S, Cook J. Heel pain: a practical approach. Aust Fam Physician. 2015;44(3):96-101.

Christie S, Styn G Jr, Ford G, Terryberry K. Proximal Plantar Intrinsic Tendinopathy: Anatomical and Biomechanical Considerations in Plantar Heel Pain. J Am Podiatr Med Assoc. 2019;109(5):412-415. doi:10.7547/17-198

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