Thursday, 28 May 2020

Stiffness on the sole of your feet in the morning?

Stiffness on the sole of your feet in the morning?

Many of you will have heard of the term “plantar fasciitis” and some will be familiar with stiffness around the heel first thing in the morning or after exercise or running. Plantar fasciitis tends to be the most common cause of heel pain and so to follow is a brief explanation of what it is but more importantly what we can do to get rid of the pain and get moving.
The plantar fascia (basically the tissue of the sole of your foot) is a flat band of soft tissue that connects the toes and the heel bone together. It supports the arch in your foot. When the plantar fascia becomes too tight, or short, it can pull against your heel bone causing pain and inflammation and so your heel will end up hurting whenever you walk or run. You can get the condition in one foot or both feet.

What causes plantar fasciitis?
Repeated over-activity and too much demand placed on it causes micro tears and shortening to the plantar fascia which causes pain, inflammation and changes to it’s normal function.
This could be from:
- a change in footwear i.e. sometimes changing our shoes in the summer from supported to flat shoes, flip flops or worn out shoes
-Increased activity levels i.e. ramping up your running too much too soon. -Postural issues, flat feet or perhaps compensations from the knee or hips causing too much pressure
-Impact to the heel I.e. stepping on something causing an injury.

How to manage and get rid?
In an ideal world (not facing the current COVID-19 restrictions) I would love to help relieve your Plantar Fasciitis with hands-on Soft Tissue Massage and provide you with a rehab plan face to face.
So, what can you do to help rehab yourself, to follow are some tips.

1 - Rest - if you are experiencing sharp/acute pain then you need to reduce your activity and avoid hard surfaces and wear good cushioned shoes. If your pain is running induced then rest and make sure you are comfortable walking before recommencing.

2 - Ice is helpful too if your pain is acute too. Place your foot on some wrapped ice for 5 mins and you can do this 3- 5 times a day.

3 - Importantly exercise and movement is good and if you pain is not too then here are some Rehab Exercises to try first of all:
- Big toes stretch and wiggle - sit with one ankle resting on your knee and with your hands stretch the sole of your foot, wiggle the toes and massage the foot whilst wiggling the toes, particularly the big toe too.

- Roll a ball on the soul of the foot - you can do this at any time seated or standing for 3 - 5mins.
- Ankle mobility - taking the ankle slowly round all in a circle, pull the toes back, point the foot and round trying to exaggerate as best you can all angles. You can do this actively and passively using your hands to assist.

- Calf stretches
a. gently drop the heels of a step and hold for 30 secs
b. Standing bend at the knee and push the knee forward and hold for 30 secs.

It is necessary to progress from these initial mobility exercises to strengthen the foot/calf muscles to better tolerate the load created by walking and especially running. It may also be necessary to consider gait and/or footwear changes.
Shockwave treatment(which I don’t offer) has also been found to have positive effects too.

This is an introduction to heel pain and how you can start to take control and manage it. If you have any questions on the above or would like some further guidance on how to manage heel pain and progressive rehab and exercise strategies then please email me.