Plantar fasciitis is a very common cause of heel pain. The plantar fascia is a thick band of connective tissue that originates at the heel bone and attaches to the base of the toes. It is designed to absorb high stresses and strains. However, too much stress can inflame and irritate the tissue, causing heel pain. Common stressors can include overuse, anatomical/ biomechanical variations, and inappropriate footwear.
The primary symptom of plantar fasciitis is a sharp pain in the heel. This often includes start-up pain when loading the foot after prolonged periods of rest or when getting out of bed. Increasing pain and tightness with prolonged weight-bearing tasks such as walking, standing or running are also common features.
- Over-pronation or excessive/uncontrolled inward roll of the feet
- Flat feet or high arches
- Being overweight
- Tight calf muscles
- Wearing poorly fitted or excessively worn shoes
- Prolonged walking, standing or running
- Quick progression of sporting activity
Treatment and Management
A comprehensive assessment of your pain, activity level, ankle and foot mobility, biomechanics and lower limb strength is required. It is also beneficial to assess your footwear. After this, your therapist will create a personalized treatment plan.
Treatment for this condition may include:
- Local massage and anti-inflammatory modalities
- Regular icing
- Gentle stretching exercises for the calf muscles and under the foot
- Taping to support the arch
- Orthotics and arch supports
- Education on supportive footwear
- Managing load of exercise/ activity-modification
- Strength and stability exercises
- Anti-inflammatory medications
According to the research, approximately 80-90% of people experiencing plantar fasciitis will have complete resolution of symptoms in 6-18 months. It will be a difficult and frustrating process for some, but not for everyone. It is sensible to be pro-active in your management before symptoms become chronic. By addressing risk factors early, you reduce the risk of a prolonged and less favourable recovery.