Now, that we have some idea about Planter fasciitis, let’s see the role of physiotherapy. As a physiotherapist, we keep a holistic management approach. Even though your main symptom would be pain at the sole of the foot, we would work on the sole area, the ankle joint, calf muscles and the TA tendon.

The main aims of the treatment would be;

• Reduce pain.
• Restore the range of movement in foot and ankle.
• Review the gait of the patient and correcting it. (Heel-toe pattern).
• Reviewing the exercise regime of the patient and other aggravating factors.
• Getting the person back to his normal routine activities.

When someone starts experiencing the pain, immediately start the RICE concept.

R – Rest the sole. Avoid prolonged standing and walking.
I – Ice the area (painful) for 15 – 20 mins every 4 hrs.
C – Compressing the area with a soft wrap reduces any kind of swelling.
E – Elevate the area by putting the foot on a few pillows esp. when sleeping.

MORNING PAIN is a very bothering symptom that patients with Plantar Fasciitis face. The first step out of the bed causes excruciating pain. This is mainly because there is no movement of fascia during sleep that leads to its tightening. So, exercise, stretch and massage your foot before you put weight on it.

• Stretch your foot by moving it (plantarflexing and dorsiflexing) 10 times.
• Place a towel on the heel and pull it towards yourself. (towel stretch)
• Walk on toes for a few steps before you put weight on the foot.

A contrast bath is recommended as the last thing to do just before you sleep. With two buckets, one with hot and the other with cold water do an 18 minutes cycle. Start with cold and end with cold. Each cold-water dip is for 3 mins and the hot water is for 2mins. So, it’s a 3-2-3-2-3-2-3 cycle of contrast bath. A night splint is recommended in chronic cases for a few days. This would keep the ankle and foot in a position that keeps Achilles tendon and plantar fascia stretched.

It is very important to warm up before exercising or playing any sport. This makes the fascia flexible and reduces the chances of injury. Post-work-out, ice the heel and do the stretches. Other physiotherapy treatments that we would generally recommend are;

• Stretching of the calf muscles and the fascia.
• Ultrasound
• Laser therapy
• Joint mobilization and manipulation
• Taping

Footwear – wear comfortable and well-supported shoes. Avoid walking barefoot even if it is for a few steps. Fascia stretches and exercises; theses help to reduce pain, improve muscle strength and flexibility in foot muscles and ligaments. A few exercises that can be done are;

• Foot movement – Stretch it towards you and in the opposite direction.
• Calf stretch  with the wall push
• Toe stretches
• Towel curls with the toes
• Marble pick-ups with toes
• Rolling a cold-water bottle under the sole of the foot.