Plantar Fasciitis :

A. Causes

• Tensile Overload: Repetitive strain and microtrauma to the plantar fascia.
• Biomechanical Faults: Excessive foot pronation (flat feet) or a rigid high arch (supination).
• Calf/Achilles Tightness: Tightness increases the pull and stress on the heel attachment.
• Inappropriate Footwear: Lack of arch support, especially in shoes worn daily.
• Sudden Activity Increase: Rapidly increasing running distance or prolonged standing.

B. Symptoms

• Heel Pain: Sharp, stabbing pain localized to the inner part of the heel bone.
• Post-Rest Pain: Pain is most severe with the first few steps in the morning or after sitting.
• Relief During Activity: Pain often decreases after walking for a few minutes.
• Recurrence: Pain returns after prolonged standing or weight-bearing activity.
• Tenderness: Localized tenderness upon palpation of the heel insertion point.

C. Diagnosis

• History: Confirmation that pain is worst after rest is the clinical hallmark.
• Palpation: Identifying point tenderness at the medial calcaneal tuberosity (heel bone).
• Differential: Ruling out nerve entrapment (Tarsal Tunnel) or calcaneal stress fracture.
• Gait Observation: Assessing for excessive foot pronation during the stance phase.

D. Physiotherapy Treatment Plan

• Stretching: Intensive stretching of the Calf muscles (Gastroc /Soleus) and the Plantar Fascia (using a ball).
• Night Splints: Used to hold the foot in dorsiflexion to passively lengthen the fascia while sleeping.
• Foot Support: Recommendation of shoes with good arch support and use of custom/off-the-shelf orthotics.
• Strengthening: Exercises for the intrinsic foot muscles (short foot exercises) and ankle stabilizers.
• Activity Modification: Temporary reduction or modification of high-impact activities.
• Taping: Application of Low-Dye Taping for immediate arch support.