DOCTOR’S CORNER with Dr JOSEPH KABUNGO
PLANTAR fasciitis is one condition that sportsman will dread to have during their career.
It is one condition that cannot be ignored and it deserves special attention because it is quite common in sports men.
A few weeks ago, I had a 21-year-old patient who came to see me because of the long-standing pain in his left heel.
He is an active football player at a first division side in Lusaka.
He explained on how difficult it has been in the past one month to play football because of the recurrent pain he has been having.
The young player has also been experiencing difficulties in putting full weight on the left leg because of the pain in the heel.
After carefully evaluating his signs and symptoms, a provisional diagnosis of plantar fasciitis was made and treatment tailored towards that.
It is for this reason that I want to go through this type of over-use injury and what soccer players and coaches must know.
Any pain affecting the foot is always a bother.
Last Sunday, I discussed pain arising from the side of the foot as another form of overuse injury.
The discussion was mainly centered on the fractured fifth metatarsal and its clinical presentation.
The signs and symptoms of a fractured 5th metatarsal where looked at and the treatment options that is available.
It is in similar lines that I want to explain some of the important things about plantar fasciitis as an overuse injury.
Plantar fasciitis can have more than one cause, I will describe how the various factor contribute to this condition resulting in pain.
The plantar aspect of the foot is the lower part while the upper part is known as the dorsal part.
The plantar fascia is a ligament type of fibrous structure that connects the heel to the bases of the five toes.
It therefore goes without saying that plantar Fasciitis is the inflammation of this strong structure that connects the heel to the base of the toes.
The plantar Fascia is important in maintaining the normal arches of the foot and helps in shock absorption when one is walking, jumping and running. Once there is irritation leading to inflammation of this structure, it results in pain that will limit the playerâ€™s ability to run.
It is also a common thing to find that, even the gait is also affected. The player will not manage to walk properly since they want to avoid exerting pressure on the affected heel.
Plantar fasciitis is mostly localised to one foot but it is not unusual to find the two heels affected at the same time.
Many football players will actually agree that they have experienced pain in the heel at one point in their career.
The common complaint in individuals suffering from plantar fasciitis will be heel pain that is worse in the morning with the first few steps.
Since it is difficult for a person to completely rest the foot, this problem will worsen with time.
The pain will result in distortion of the way someone walks because there will be avoidance of bearing full weight on the affected foot.
Plantar fasciitis in football players or sports men generally must be seen to be an overuse injury.
Overuse injuries are as a result of repeated micro trauma to the affected part. This happens over a prolonged period of time and ultimately results in the inflammation of the affected structure and in this respect it is the plantar fascia that is affected.
One common cause of plantar fasciitis is that one associated with tight calf muscles or tight Achilles tendon.
With repeated training and sometimes, inadequate recovery time, this will result in tightness in the muscle.
It must be remembered that the calf muscle is attached via the Achilles tendon to the heel, which is also an attachment point for the plantar fascia. The plantar fascia attaches to the heel or calcaneum and goes all the way to the bases of the toes.
Once this is appreciated, then it is easy to understand why, calf muscle tightness will lead to irritation and subsequent problems associated with plantar fascia.
The other cause of plantar fasciitis is related to the weak muscles of the foot. The foot has got small muscles within itself that are responsible for various actions.
It is the weakness of these muscles which will result in inflammation of the plantar fascia.
The other causes of plantar fasciitis are sudden increase in activity or training and this is the reason why training has to be done in a well structured manner in order to prevent some of these overuse injuries.
Weight has got its own problems in sport.
In some instances, an individual who has gained weight, will tend to suffer problems associated with the plantar fascia.
The added weight of an individual will result in more weight transmitted to the foot.
It is the reason why inactive sportsmen have to be concerned about maintaining there weight so that they do not only become slow to run but also avoid some of these injuries like plantar fasciitis of the foot.
The type of running or playing shoes that an individual has also plays an important role as a cause of this condition.
Playing shoes or football boots have to be comfortable to an individual so that the stress on the foot is reduced,
It is not recommended to wear a shoe or football boot meant for wet conditions on a hard and dry pitch.
This will result in plantar fasciitis and the player or athlete will get injured.
It is not all about the elegance or fashion related to the type of playing shoes, but a player must be very careful in the choice of the training or playing shoes.
The best way to avoid getting plantar fasciitis is by reducing some of the risks associated with this condition.
Good training patterns and recovery in between training sessions is important.
Most of the playing surfaces, which we use in our country are not soft and the use of football boots with a hard sole is not advisable and also avoid the six studded boots which are meant to be used in wet and soft playing surfaces.
The coaches also have to be mindful on the loading and training pattern, which they subject their players to.
It is important that players who are having tight calf muscles and the Achilles tendon receive the appropriate treatment from physiotherapists. Ignoring a tight Achilles tendon tightness is not only a risk factor but can lead to ruptured or torn Achilles tendon.
The effective treatment of this condition has to be targeted at reducing the pain.
There has to be restoration of flexibility to the tight structures around the ankle joint and the arch of the foot.
The muscles of the foot have to be put under a good muscle strengthening exercise programme.
For questions and comments write to Dr Kabungo Joseph
Emailfirstname.lastname@example.org Or email@example.com
DOCTOR’S CORNER with Dr JOSEPH KABUNGO