Plantar Fasciitis

pronounced ("PLAN-tur fash-ee-EYE-tus)

This is the most common heel pain complaint we see in clinic. It is an inflammatory condition of the plantar fascia caused by micro tearing of the tissues of the fascia which connects to the heel bone. It is an overuse injury caused by running/walking/standing for long periods of time, especially when you are not conditioned to that activity. A change of surface (eg. road to track), poor shoe support, being overweight, sudden stretching of your sole as well as a tight Achilles tendon can a be causative factors. As Podiatrists we expect to see this condition in clinic in the autumn after people have been wearing flat sandals in the summer and it is very common in the 40-60 age group.

How do I know I have Plantar Fasciitis?

Plantar Fasciitis presents as severe pain under the heel in the morning when taking the first few steps out of bed, or when standing up after sitting for long periods of time. The pain can appear to subside after being on your feet but returns later on that day. The pain is not there when sleeping and would not wake you up in the middle of the night. The heel affected will often be warmer and can be slightly swollen. The pain can often radiate around the heel area and sometimes feels like it is around the edge coming up the inside of the heel into the arch of the foot.

What can I do to help myself?

Rest from any activity that you may be doing
Ice application to the heel little and often during the day, a bag of garden peas is as good as ice
Wear supportive footwear inside the house and out, avoiding any shoes that are flat
Take up swimming as an alternative non- weight bearing activity
Loose weight if you have put weight on in the last year. When walking 3x your body weight is transferred through your foot and 9x when running, so a half a stone increase in weight becomes 11/2 stone and 41/2 stone respectfully

What can a Podiatrist do for you?

Initially diagnose that it is Plantar Fasciitis, there are 40 conditions that affect the heel so it is important to address and treat the correct one.

Evaluate the trigger that caused the Plantar Fasciitis because if that is not identified then the chances of recovery are limited.
Give the correct footwear advice- certain shoes can be the cause of plantar fasciitis so recognising those ones are really important. Some makes of shoes can actually help plantar fasciitis recover so advising patients of these types can facilitate a quicker recovery.
Applying padding and strapping to reduce the strain on the fascia, this can give instant relief and the strapping will stay in place for a week and then can be reapplied if required.
The Podiatrist can make heel pads or suggest heel cups for your shoes to cushion the heal area.
Low level Laser application (Photobiomodulation) which encourages healing of the damaged tissues, relieves pain and reduces inflammation.
Foot, Ankle and Soft tissue Mobilisation- Podiatrists can mobilise (pain free) the joints and soft tissues to release the tension that is present, enabling the structures to move smoothly again reducing the stiffness that can often happen after a trauma to the plantar fascia.
Orthotic prescription (special insoles) to correct any underlying structural abnormality that may be causing the extra stress on the plantar fascia, if this is not addressed the problem may repeat again at a later date.
Stretching and loading exercises at the correct stage of rehabilitation as doing them too soon could increase the irritation of the planter fascia and make it worse.
A referral for a steroid injection may be recommended to be done by the Gp if after several months of non- surgical treatment, it is still unresolved.
Surgical intervention may be a consideration in repairing the fascia but that is only when the Podiatrist feels that is the correct treatment option for you and a referral will be facilitated

Plantar Fasciitis takes time to recover from and establishing the causative factors is very important to a resolution. The sooner it is addressed the quicker it will heal, once the cause has been established the chance of re-occurrence is limited.

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