Plantar Fasciitis Symptoms
Symptoms: Sharp pain over the heel and aching pain along the underside of the foot are signs of plantar fasciitis. Pain often increases when more time is spent in standing or walking.
Causes: This condition is caused by excessive stretching of the plantar fascia, which is the strong “spring-like” ligament that runs along the arch of the foot. Typically this is more prevalent when people have either flat feet or very high arches. A long history of wearing high-heeled shoes can be a contributing factor in females.
Relief: Hands-on joint mobilization can relieve ankle stiffness, and stretching tight calf muscles can improve ankle movement. Myofascial release of the plantarfascia helps prevents scar formation, and strapping techniques decrease stress on the plantarfascia. If an orthotic shoe insert is needed, the therapist will either suggest an “over-the-counter” orthotic or refer the patient to a podiatrist for a more specialized orthotic.
Symptoms: Pain and swelling of the Achilles tendon where it attaches to the heel bone and slightly above indicates Achilles tendonitis. Symptoms get worse with weight-bearing activities and may develop suddenly or gradually.
Causes: Achilles tendonitis accounts for over 10% of all running injuries and is also common in jumping activities such as basketball. Beginning or increasing an activity or even simple walking can lead to the onset of this condition. It occurs when calf weakness or tightness or poor foot biomechanics make the tendon vulnerable to stress.
Relief: Hands-on myofascial release of the calf muscle and Achilles tendon help prevent scar formation. “Eccentric” exercises, which develop tension while the muscle is lengthened, help restore pain-free flexibility of the calf. Ultrasound, ice and electrical stimulation relieve soreness while the exercise promotes healing. Taping, orthotics and footwear changes may also be needed.
Symptoms: Pain and tenderness along the inside of the shin bones may indicate shin splits. Often symptoms come on with activity, then ease as activity continues, but return after activity ends. Occasionally bumps, swelling or warmth can be felt along the shin bone.
Causes: This is often a sports-related injury caused by stretching of muscle attachments along the shin bone during weight-bearing activities. A very flat foot can increase this traction force. Over-striding or forcible striking of the heel during walking, running or marching are also frequent causes. This explains why shin splints are common in the military.
Relief: Rest from the aggravating activity is the first priority. If this problem is not appropriately managed, it may develop into a stress fracture. Localized massage can release muscle tightness. Exercises include calf stretching to reduce resistance and strengthening of the stressed muscle groups to help absorb force. Ultrasound and ice can ease inflammation. For those people with a very flat foot, taping and orthotic inserts may help. A graduated return to sport needs to be supervised by the therapist.
Symptoms: Sprains may result in swelling and pain on the outside of the ankle near the ankle bone, limited movement, and sometimes inability to bear weight.
Causes: “Turning” or “rolling” of the ankle in an accident may over-stretch the ankle ligaments. The severity can vary significantly. A simple Grade 1 may limit activity for one to two weeks while a Grade 3 may hobble you for up to two months. This is the most common injury physicians treat, and it has the highest rate of recurrence. Hence the need to ensure complete rehabilitation.
Relief: Treatment begins with simple range of movement exercises and manual therapy to restore ankle joint mobility. Of more importance is the late stage of rehabilitation where exercises retrain the surrounding muscles to protect the ligaments from re-injury. This “proprioceptive” re-training is often overlooked by therapists and physicians, which explains the high rate of recurrence.