The Plantar Fascia is a long piece of connective tissue that helps to maintain and support the arch of our foot whilst weight bearing and doing dynamic movements such as running and jumping. This connective tissue acts as a truss mechanism like a suspension bridge to ensure the foot maintains the correct mechanics when going through extreme weight bearing movements.
When you have injured the Plantar Fascia you may feel a sharp pain on the bottom of you heel or in the midfoot when taking your first steps in the morning or after a intense session of physical activity with lots of Jumping/running.
The cause of plantar fascia is usually due to a dramatic sudden increase in the amount of physical activity being done. Usually we see just an acute inflammation of the plantar fascia which we can help address through, taping, massage, calf and foot muscle strengthening exercises and can usually be dealt with and managed within 6-8weeks. But for the more serious injuries due to trauma, where you might have torn the plantar fascia insertion off the heel, this is a more extensive recovery and is what I want to talk about.
First step is to get it examined and, in most cases, if pain is severe and persistent, get it scanned with an Ultrasound or MRI. Once it is concluded that there is a complete or partial tear of the plantar fascia, we need to let that structure heal by “de-loading” it. This usually includes wearing a moon boot as well as having the foot supported with taping in the moon boot. This is accompanied by Physiotherapy aiming to maintain the range of motion of the ankle, if we don’t address this, our ankle becomes stiff and a normal walking pattern is hard to regain once out of the moon boot.
Once that structure has healed in around 6 weeks we can start strengthening exercises to rebuild the strength of the calf and foot muscles. This will take a further 6 weeks of physiotherapy and then we can be sure that the Plantar Fascia has fully healed, and we can resume running, jumping movements and return to sport.
In worse case scenarios, surgery (Plantar Fascia release), Platelet Rich Plasma Injections or cortisone injections may be used to settle persistent pain or aid recovery. This is a last resort and if the above steps are followed correctly then these treatments should not be needed.
I myself have had a complete Plantar Fascia tear of my Right foot playing AFL and was back on the field in exactly 12 weeks without any surgery or injections.
John Macansh
Physiotherapist
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