What is plantar fasciitis?


Irish dancers with plantar fasciitis may notice heel pain that gets progressively worse during dance practice and training. If left untreated for a period of time, the pain can become much worse or more frequent. This can result in a dancer pulling out of competition and dance practice sessions.

Plantar fasciitis is one of the most common injuries that I treat for Irish dancers, treating dozens of dancers with this issue each year. Understanding the condition, its symptoms and how to treat it can help sufferers alleviate pain and get back to dance class!

What is Plantar Fascia and where did the name come from? 

Plantar is the term used to refer to the bottom of your foot and fascia is known as fibrous connective tissue. So Plantar fascia is fibrous connective tissue on the sole of the foot. This fibrous band of tissue begins at the heel bone (calcaneous) and attaches to the long bones called the metatarsals, at the ball of the foot.

The plantar fascia helps to arch the foot and helps with movement and stability. When you rest the foot, the muscle shortens. When you stand the muscle lengthens. When you walk, run or jump, your foot hits the ground and as a result, the plantar fascia stretches and then it rebounds and contracts to help you to push off the ground again. Walking, running, jumping and dancing of course, causes the plantar fascia to stretch and contract repeatedly. This repeated stretching and contracting can cause small tears called micro tears to develop and can cause inflammation of the plantar fascia. This is where the term plantar fasciitis comes from. These small tears and inflammation usually occur where the plantar fascia is attached to the heel bone, which will explain to you why you may be experiencing pain at the heel. The small tears and inflammation may not always happen at the same time and if this is the case this is and if there is no inflammation present, this is called plantar fasciousis.

Plantar fasciitis and sleeping

People with plantar fasciitis often experience heel pain after a nights sleep. This is because your foot rests at a specific angle which then allows the fascia to shorten. Then when the person stands the foot changes position and the angle changes too causing the fascia to stretch when you apply weight causing pain. Sometimes I advise my clients (depending on the situation) to wear a brace when sleeping which keeps the foot at a 90-degree angle. Therefore, when you wake and apply pressure to the foot there isn’t as much change in the angle of the foot and the length of the muscle, causing you less pain. (I would not recommend this without seeking advice on your situation first).

Symptoms

Some people may not experience any symptoms over the course of days or even weeks. A lot of dancers who come to see me with this issue, usually experience minor issues weeks before they get any help. This is because they might only experience pain for a short period of time during practice and then it might go away again. It is only when this happens more frequently or when the pain is constant during activity when most people see a health professional, hoping they can then resolve the issue. In my opinion and speaking from my own personal experience, if you don’t leave it too long to treat it, this issue can be resolved very easily. To help you identify common symptoms, here is a list:

Sharp heel pain: This pain is usually located at the inside of the heel just behind the arch of the foot.

The pain is most noticable after a nights rest and getting up out of bed in the morning.

Heel pain when pressure is applied. Pressing the bottom of the heal can be tender. Walking and limping to avoid pressure on the heel is also a sign.

Plantar flexing and dorsi flexing the foot can be uncomfortable.

Achilles tendon issues can also make the plantar fasciitis more painful.

What should I do to avoid doing more damage? 

Foot pronation or flat feet – if you have this issue, then you may have suffered from plantar fasciitis at some point or you may have experienced plantar fasciousis. Why am I saying this? Its because everytime you jump and land you are more than likely putting extra pressure on the inner foot, which can strain the plantar fascia. How can you fix this issue? The reason why people suffer from foot pronation or flat feet is another subject of its own… it is not a one answer question, there could be a few reasons why you have foot pronation or flat feet and I wouldn’t be able to give you an answer without assessing you first. My advice to you is to try to solve the issue if you would like to continue dancing without experiencing plantar fasciitis symptoms. I can access you via video call or in person if you wish to make an appointment.

Running, Walking, Jumping – If you have been experiencing plantar fasciitis symptoms then I recommend that you stop walking long distances, standing for long periods of time & jumping. This obviously means that dancing should be avoided until the issue is treated, diagnosed and the correct rehabilitation plan is put in place. If done correctly, it should not take long for the dancer to recover and therefore they will not miss out.

Not enough activity – Too much of the above can be harmful but so can too much rest. When the plantar fascia rests, the muscle shortens, making it less flexible. This is why correct programming is important.

Possible Treatment options (in-house):

Rest: Avoiding running, walking, standing for long periods and dancing as mentioned above for a period of time (few days to a couple of weeks) can help the fascia to heal. But know that from my experience, if there are small tears in the fascia a treatment would still be necessary if you wan to make a full recovery.

Footwear: Sometimes the shoes we choose are not always suitable. Soft shoes with proper arch support are recommended.

Taping: I sometimes use taping techniques to support the fascia, giving it a chance to heal properly.

Shoe Inserts: They are not always my favourite option and they can be expensive but for some people it is necessary. An assessment would need to be carried out before discussing this in further detail. A heel cushion is another possible option.

Program: A suitable program is always important. I always assess the client, diagnose the injury, find the reason why it occurred and program to solve the problem and to avoid re-occurrence.

Icing. Is this necessary?

If you have read previous blogs or if you have met me in person you will know my thoughts on people using ice. Yes, I do recommend ice for some injuries but for most, if you can avoid it, do! Again, I would need to assess the client to know for sure if ice is needed. If you decide to use it anyway, then I recommend that you only focus on the area of pain and not the surrounding areas. For example: If you have pain at the heel, then I recommend that you only apply ice to the heel and not to the surrounding areas including the plantar fascia.

Physical Therapy

For some reason, not all experts agree with physical treatment and hands-on manipulation but from my experience, it definitely helps if the correct treatment is carried out.

If you have any questions on this subject or if you have another injury that you need help with, feel free to leave a comment or message us on our website, facebook or instagram page.

As always, thank you for reading.

Your Author & Head Coach

Peter O’Grady