Plantar Fasciitis (Heel pain)

What is it?

Plantar fasciitis is a fairly common condition and will typically affect those who spend a lot of time on their feet. The affected structure is the plantar fascia which is a thick connective tissue under the foot. The role of the plantar fascia is to support the arch when standing and absorb shock when walking. Sometimes the plantar fascia can become irritated and inflamed where it inserts into the bottom of the heel. This is known as plantar fasciitis

Typical symptoms

  • Pain felt underneath or toward the inside of one or both heels.

  • The pain is often described as walking on a pebble or a bruise. Sometimes there can be some tingling or shooting pain.

  • The pain is often worst upon rising in the morning or getting back onto your feet after sitting for prolonged periods of time.

  • The pain often eases as you ‘warm up’.

  • When chronic, the pain may be present all day

What causes it?

  • Poor foot biomechanics

  • Poor footwear

  • Spending a lot of time on your feet

  • A sudden change in activity (e.g. starting a new exercise regime)

  • Walking or standing on hard surfaces

  • Weight gain (including pregnancy) or if you are overweight

  • Climbing up and down ladders

  • Jumping down from a height

  • Climbing in and out of trucks or cars frequently

Treatment

Short Term

Finding the cause is first and foremost.

Padding and/or strapping to the affected foot. This is to be kept on and dry for three days. Remove at the first signs of any irritation (itchiness, redness, swelling).

Use a tennis ball to massage your feet. Do this especially before rising after rest (e.g. before getting onto your feet in the morning).

Use a frozen water bottle to massage your feet. Do this at the end of the day when/if your feet are sore. Apply for ten minutes, then 10-20 minutes off and so on.

Try to wear your most supportive pair of shoes as much as possible. Your podiatrist will also give you footwear advice.

Calf and foot stretches should be done every morning before rising, during the day and before bed.

 

Long Term Considerations

Orthotics

Cortisone injection

Surgery to remove associated heel spurs