What is Plantar Fasciitis?

Plantar fasciitis is a band of tissue under the foot that stabilises the arch and acts as a shock absorber protecting the underlying soft tissues during gait (walking). Repeated pulling of this such as overuse injuries e.g. sporting activities, excessive pronation of the subtalar joint (ankle joint) are potential contributory factors leading to degenerative changes of the plantar fascia.

Acute injuries or chronic inflammation may result in partial tearing and/or calcification (bony spur formation) at the origin of the plantar fascia.

What are the symptoms?

Plantar fasciitis is reported to be usually self-limiting. Typical symptoms that may be present when first weight bearing in the morning and perhaps during periods of inactivity are: throbbing, searing, piercing pain.

What can you do about it?

Footwear – Shoes or trainers with a lace up or fastening and thicker soles may help, especially those who are walk/stand for long periods. Footwear should have good shock absorption. Sometimes implementation of orthotics may have to be considered to provide shock absorption and/or control any biomechanical dysfunction occurring in the foot/ankle.

Cold therapy – this may help in the initial stages of injury reducing irritation, pain and swelling. Application of a cold stimulus (e.g. ice pack) provides an analgesic effect. However, prolonged application could be harmful, causing frostbite and should be avoided. Contraindications include patients with peripheral vascular disease, neuropathy and vasospastic disorders (e.g. raynauds). Suggested cold therapy can be achieved by rolling the foot over an iced can/bottle, which provides a combination of cold therapy and stretching of the plantar fascia.

Exercises – weight bearing activities should be initially avoided and suggest perhaps swapping to swimming, low-resistance cycling.

Plantar fascia stretching – Initial morning (ideally before getting out of bed) non-weight bearing plantar fascia-stretching may help promote tension relief. This exercise requires the individual to sit upright crossing the affected leg over the other, placing their fingers over the metatarsalphalangeal joints and extending the toes towards the shin – holding for 10 seconds (10 repetitions, 3 sessions daily). A stretch/tension should be felt in the arch of the foot. Please note this should not be painful. This exercise may also be performed after any sitting/resting periods throughout the day.

Achilles tendon stretching – this exercise requires the patient to stand forward towards the wall, placing one leg behind the other (keep back straight). The patient is to lean into the facing wall with the front knee flexed and the back leg fully stretched behind (both feet firmly on the ground). Hold this position for 10 seconds (repeat 10-20 times, 3 times daily). Repeat the exercise, but with the back knee slightly bent.