Plantar Fasciitis: Understanding Heel Pain and How Osteopathy Offers Holistic Relief
That sharp, stabbing pain in your heel or along the arch of your foot—particularly with your first steps in the morning—is a hallmark sign of plantar fasciitis. This common yet often stubborn condition involves irritation and degeneration of the thick band of tissue (the plantar fascia) that supports your foot's arch. While frequently labelled an overuse injury, it often stems from underlying biomechanical imbalances.
Osteopathy provides a comprehensive, whole-body approach to managing plantar fasciitis. We look beyond the painful heel to assess and treat the interconnected structures—from your foot and ankle to your knee, hip, and spine—that contribute to excessive strain on the plantar fascia.
Key Facts About Plantar Fasciitis
A Degenerative Condition: Modern understanding classifies it as a "fasciopathy" involving failed healing and tissue degeneration, rather than simple inflammation ("-itis").
A Common Complaint: It is one of the most prevalent causes of heel pain, affecting a wide range of people, from runners to those with more sedentary occupations.
Linked to Load Management: It typically occurs when the load or tension on the plantar fascia exceeds the tissue's capacity to recover, often due to changes in activity, footwear, or weight.
Common Causes and Contributing Factors
Plantar fasciitis rarely has a single cause. It usually results from a combination of factors that increase stress on the plantar fascia:
Biomechanical Dysfunction: This is a primary osteopathic focus. Issues such as overpronation (flat feet), high arches, or tight calf muscles (gastrocnemius and soleus) alter how forces travel through the foot, placing extra strain on the fascia.
Sudden Increase in Activity: A rapid change in walking, running, or standing duration, especially on hard surfaces.
Inappropriate Footwear: Shoes with poor arch support, thin soles, or inadequate cushioning.
Weight: Increased body weight raises the load borne by the feet with each step.
Lumbopelvic and Lower Limb Mechanics: Dysfunction in the hips, knees, or pelvis can change your gait pattern, affecting how your foot strikes the ground. Tightness or weakness in the glutes or hamstrings can also contribute indirectly.
Common Signs and Symptoms
Sharp, Stabbing Heel Pain: Most severe with the first few steps after waking or after long periods of rest.
Pain Location: Typically at the inside-front of the heel bone (calcaneus), where the plantar fascia attaches. Pain may also travel along the arch.
Pain That Eases Then Returns: Pain often lessens with gentle movement but returns after prolonged standing, walking, or towards the end of the day.
Stiffness: Significant foot stiffness, especially in the morning.
Tenderness: Pain when pressing on the heel or along the arch.
How Can Osteopathy Help with Plantar Fasciitis?
Osteopathic management focuses on reducing pain, improving tissue health, and, most importantly, correcting the biomechanical faults that are overloading the plantar fascia. We treat your body as an integrated unit.
During your initial consultation, we will:
Take a detailed history of your pain, activity levels, footwear, and overall health.
Perform a thorough physical examination of your foot and ankle, assessing range of motion, flexibility, and palpating for tender points.
Conduct a comprehensive biomechanical assessment of your gait (how you walk), and the mobility and function of your knees, hips, pelvis, and lower back.
This is crucial because the cause of your foot pain may originate higher up the kinetic chain.
What Does Osteopathic Treatment Involve?
Using gentle, hands-on techniques, we aim to:
Reduce Local Tension and Improve Circulation: Gentle soft tissue techniques to the foot, calf, and lower leg muscles can help alleviate tightness and support tissue healing.
Restore Joint Mobility: Gentle mobilisation of stiff joints in the foot, ankle, knee, and hip can help ensure normal, efficient movement and reduce compensatory strain on the plantar fascia.
Address the Root Cause: We treat identified dysfunctions elsewhere in the body. For example, improving mobility in a stiff hip or strengthening weak gluteal muscles can correct your walking pattern and reduce pronation.
Provide Personalised Advice and Rehabilitation: You will receive guidance on:
Load Management: How to modify activities to allow healing while maintaining fitness.
Stretching Program: Specific, sustained stretches for the calf muscles and plantar fascia.
Strengthening Exercises: For the intrinsic foot muscles and lower limb stabilisers.
Footwear and Orthotic Advice: Recommendations on supportive shoes and discussion on the potential role of heel pads or orthotics as a temporary measure.
Self-Massage Techniques: Such as rolling a frozen water bottle under the foot for pain relief.
When to Seek Further Medical Help
It is important to get a correct diagnosis. Please consult your GP or podiatrist for a formal diagnosis and to rule out other conditions like stress fractures or nerve entrapments. Seek prompt medical advice if:
Your heel pain is the result of an acute injury.
You notice significant swelling, redness, or warmth in the heel or foot.
You have numbness or tingling in your foot.
The pain is severe and prevents you from bearing weight.
You have a fever or signs of infection.
Symptoms do not improve after several weeks of conservative care.
Take a Step Towards Lasting Relief
Plantar fasciitis can be frustrating, but with a structured approach that addresses the underlying causes, recovery is very achievable. Osteopathy offers a drug-free, holistic pathway to not only ease your pain but also to restore balanced function and help prevent recurrence.
Click here to schedule an appointment with one of our experienced osteopaths. Let us help you walk comfortably again.
References
Schwartz, E. N., & Su, J. (2014). Plantar fasciitis: a concise review. The Permanente Journal, 18(1), e105–e107. [Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3954276/]
*Riel, H., Cotchett, M., Delahunt, E., et al. (2019). Is there a dose-response relationship between foot orthosis use and clinical outcomes in plantar heel pain? A systematic review and meta-analysis. British Journal of Sports Medicine, 53(18), 1164-1171. [Link: https://bjsm.bmj.com/content/53/18/1164]*
Australian Institute of Health and Welfare (AIHW). (2020). Musculoskeletal conditions. [Link: https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions]
Disclaimer: This blog post provides general information only and is not intended as a substitute for professional health advice, diagnosis, or treatment. Always consult a registered health practitioner, such as your General Practitioner (GP), podiatrist, or osteopath, for diagnosis and treatment of health conditions. The management of plantar fasciitis often benefits from a multidisciplinary approach. Osteopathic care addresses musculoskeletal contributors throughout the body and should be considered a complementary therapy alongside other modalities as appropriate. Individual results from osteopathic treatment may vary based on the individual’s specific condition and adherence to rehabilitation advice. The information provided is based on the best available evidence at the time of publication.