Managing Plantar Fasciitis

What is Plantar Fasciitis?

Plantar fasciitis is a common cause of heel pain, resulting from inflammation or degeneration of the plantar fascia—a thick band of tissue connecting the heel bone to the toes, supporting the arch of the foot.

Common Presentations

  • Sharp, stabbing heel pain, especially with the first steps in the morning or after prolonged sitting

  • Pain that decreases with gentle activity but worsens after prolonged standing or vigorous exercise

  • Tenderness along the bottom of the foot, particularly near the heel

Managing Plantarfasciitis
Causes of Plantar Fasciitis

Common Causes

  • Overuse or repetitive strain from activities such as running, walking, or standing for prolonged periods

  • Poor footwear lacking adequate support

  • Excessive body weight placing extra strain on the plantar fascia

  • Stiffness in calf muscles or Achilles tendon

  • Foot mechanics issues, such as flat feet or high arches

Prognosis

Most cases improve significantly within 6-12 months through conservative management, though early intervention typically speeds recovery and prevents chronic issues.

Assessing Plantar Fasciitis

Clinical assessment usually involves:

  • Detailed patient history, noting onset, triggers, and activity levels

  • Physical examination, including palpation of the plantar fascia and evaluation of foot biomechanics

  • Imaging (such as ultrasound or X-rays), if indicated, to rule out other conditions like heel spurs or fractures

Evidence-Based Management

Current clinical guidelines recommend:

  • Stretching Exercises: Particularly calf and plantar fascia stretches

  • Manual Therapy: Techniques such as soft tissue mobilisation, myofascial release, and joint mobilisation to enhance flexibility and reduce pain

  • Activity Modification: Reducing or altering activities that aggravate symptoms

  • Footwear and Orthotics: Supportive shoes or custom orthotics to relieve pressure on the plantar fascia

  • Pain Management: Short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) as indicated by clinical guidelines

  • Other Therapies: Consideration of therapies such as shockwave treatment or taping in persistent cases

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