It’s flip flop season and with a change of footwear perhaps you have noticed your calves feeling a bit tighter in the morning. So why is this?
When we wear flip flops and less supportive shoes such as ‘pumps’ (staple summer footwear for many), these shoes have flimsy and practically non-existent soles with minimal shock absorption. We then load up the fibrous layer (plantar fascia) on the underside of the foot and the calf, which tightens up as a result.
Plantar fasciopathy is a common condition affecting both active and sedentary people, though it’s more common in women particularly over the age of 40. There are many risk factors including overload, perhaps from a change in training intensity, flat feet or dropped arches, tight calves, wearing heels or being overweight.
Pain typically occurs at the heel bone where the fibrous tissue, the plantar fascia, inserts. It is usually painful to press in a specific area, is particularly stiff and sore first thing in the morning, or it can be the case after sitting for a while and then standing up.
Physiotherapy can be very effective in treating plantar fasciopathy but it can be a very stubborn condition and, given its location, it’s a difficult area to rest.
The longer plantar fasciopathy goes on, the more chronic it becomes and it can become trickier to rehab with physiotherapy alone.
Some people benefit from steroid injections – although this is quite a nasty area to have an injection due to the lack of flesh. Another option is shock wave therapy, which has also shown to be effective as a treatment option.
For effective treatment it’s important to look at the whole body and what we call the kinetic chain – finding out the source of the problem as tight calves can manifest from other issues or faulty movement patterns at the pelvis, hip and knee.
Physiotherapy typically includes calf stretches, Achilles stretches, fascial stretches, rolling a spiky ball under the foot, icing, footwear advice and sometimes taping, in addition to identification of weakness in other muscle groups likely to be contributing to over loading the fascia.
In summary, it can be quite a painful condition but physiotherapy often yields excellent results, especially if advice and treatment is sought early. As always, get in touch with any concerns.