The plantar fascia is a thick fibrous band of connective tissue extending from the calcaneus (heel) to the base of the toes. Plantar fascia will consist of acute or chronic irritation.
1) A LITTLE ANATOMY:
The plantar fascia is a thick fibrous band of connective tissue extending from the calcaneus (heel) to the base of the toes. Due to its rigidity, it supports the medial arch of the foot, absorbing shocks when pressing down on the ground and then when rolling the foot. It finds its maximum stretch when it must support the entire weight of the body.
2) PLANTAR FASCIAPATHY? PLANTAR APONEURITIS? PLANTAR FASCIITIS ?
The low elasticity of this membrane gives it low resistance to repeated or unusual stresses… which can lead to fasciapathy. This pathology will therefore consist of an acute or chronic irritation of this aponeurosis.
The term fasciitis, although the most widespread, is therefore partially erroneous, because the pathology seems to be linked more to mechanical irritation than to real inflammation.
3) WHAT ARE THE LESION MECHANISMS?
This injury is linked to repeated micro-traumas, creating progressive irritation of the aponeurosis. The causes are therefore regularly the same:
Intensive practice of a sport, in particular those involving repeated shocks (eg running)
Sudden change in training volume or intensity
Unsuitable equipment (worn shoes, etc.)
Poor motor control and muscle weakness
Bad technique in the sporting gesture
4) WHAT ARE THE SYMPTOMS?
This type of injury can appear gradually or following a specific event. The intensity of the problem will produce more or less severe symptoms. Among these are:
A precise and localized pain under the arch of the foot, at the front of the heel
Morning pain and stiffness, usually dissipating after a few steps
Pain reproduced when standing on tiptoe or jumping
In more severe cases, this pain may be constant and present even at rest.
5) IS IT SERIOUS?
Fasciapathies are frequent pathologies which are generally got rid of quite easily and quickly during early treatment.
However, they can become problematic and more difficult to treat when they have been present for a longer time, and when the intensity is high.
6) IS SURGERY AN OPTION?
The surgical procedure remains exceptional and will only be considered in the event of repeated failures of conservative treatments or in the event of complications linked to the absence or poor initial treatment.
7) CAN I CONTINUE TRAINING? WHAT REFLEXES SHOULD I TAKE?
Plantar fasciopathy needs to be taken seriously from the start in order to avoid complications and aggravations.
At the onset of the first symptoms, a temporary cessation of activities that cause pain is recommended. These activities can be replaced by others that unload the fascia, such as cycling and swimming.
Temporary wearing of more cushioned shoes can also help.
Finally, refrain from applying ice and taking anti-inflammatories, as these modalities generally interfere with the healing of the fascia.
Then, it is the importance of the symptoms and the improvement of the situation that will determine the duration of the relative cessation of the activity.
The best option should be discussed with your doctor.
8) HOW DOES THE REHABILITATION TAKE PLACE?
The physiotherapy sessions start by paying attention to the painful symptomatology of the subject. Respecting this, the work will focus on:
The work of joint mobility and tissue flexibility
Gradual rehabilitation of the joint and fascia
Global and specific muscle strengthening (strength, neuromuscular control, stability, etc.)
Re-athletics and getting back into sport (with technical work if necessary)
9) WILL I RETURN TO MY PRE-INJURY LEVEL?
This pathology, although having a favorable prognosis, needs to be taken seriously from the start.
However, provided you follow the instructions and recommendations provided by your surgeon and your therapist, your child will return to normal sports activity.
10) WHAT CAN I DO TO SPEED UP THE PROCESS?
You are the main actor of your rehabilitation!
In order to speed up the healing process, be sure to follow the recommendations of the health professionals with whom you work.
Laziness or, on the contrary, overzealousness, will be your enemies. Conversely, discipline, rigor, perseverance as well as a positive and voluntary state of mind will help you get back in top shape as soon as possible!