Plantar fasciitis is a stretching or inflammation of the tissue that run along the sole of the foot. The plantar fascia is a collection of connective tissue originating at the bottom of the heel and progressing toward the ball of the foot. It helps maintain the arch and acts as an impact absorber during soccer.

Mechanism of Injury

Usually a chronic condition, factors contributing to plantar fasciitis include:

• a high arch or a fallen arch/flat (pronated) feet with inadequate arch support in soccer cleats or turf shoes
• weak or inflexible muscles in the lower leg and foot
• playing on hard surfaces, such as turf fields
• running on softer surfaces, such as wet grassy field, allows for increased pronation, which can lead to repetitive strain
• female soccer players with an increased Q-angle at the hip causing knock-knees and a tendency to overpronate

Signs and Symptoms

• Pain along the arch or near the bottom of the heel.
• Feeling of muscle tightness or weakness.
• The arch may flatten out.
• Inability to push off with the foot or point the foot down.
• Pain and an inability to walk without limping (especially in the morning after rising from bed, or after sitting for prolonged periods).
• There may be evidence of nodules (or lumps) on the underside of the foot, especially near the calcaneus (heel).

On-Site Management

P.R.I.C.E. PROTECT the area from further injury (i.e. orthotics, taping). Start with store bought orthotics first and if it does not help see a physiotherapist about custom made ones. REST the area to promote healing. It is important to take some time off from intense leg exertion to give the tissue time to heel. ICE the area for 10-20 minutes to move inflammation away. COMPRESS the area by rolling your foot on a tennis ball to stretch out the connective tissue that is tight. ELEVATE the area to promote circulation towards the heart, especially during icing.

Referral. A physician can prescribe anti-inflammatory medication or other treatments. If the condition does not resolve on its own or after doing the suggestions here then see a sports medicine practitioner for further help.

Rehabilitation. Strengthen the muscles of the foot (towel curls, picking up objects with the toes, etc.). Stretching of the calf muscles and the plantar fascia itself is very important (tennis ball stretch or pull on big toe). This should be done 3-5 times per day.

Return to Activity. Heel cushions in your soccer cleats or turf shoes and taping the arch for support are often useful when returning to activity.

Prevention

• A soccer cleat or turf shoe with good arch support will help prevent this injury.
• Proper orthotics can also be used for soccer players with low arches.
• Flexible calf muscles can help reduce the risk of injury.
• Use turf shoes instead of cleats for practice on a turf surface.

Copyright held by SportMedBC. For information contact info@sportmedbc.com.