Many patients live with undiagnosed or poorly managed plantar fasciitis. This can be unnecessarily debilitating for people as it can often be fully relieved with the right treatment and advice. The plantar fascia is a soft tissue structure which runs along the sole of the foot from the heel (calcaneus) to the base of the toes. Its role is to maintain and support the intrinsic structures within the foot. As a result of this crucial role, along with its need to redistribute body weight and ground forces, it is a vulnerable structure.
In plantar fasciitis, the plantar fascia becomes inflamed or thickened due to damage or injury. This can result in heel/ foot pain due to damage to, and pressure on other structures in the foot. The pain is commonly felt where the injured plantar fascia inserts in the foot.
– Heel pain often noted as a stabbing pain with the first few steps in the morning or after rest
– Pain provoked by exercise, especially on hard surfaces (although the pain is usually after exercising, not during)
– Pain elsewhere due to compensation for heel pain leading to added strain on other areas such as back and hips
– Tight calves
– Inappropriate footwear and support
– Inappropriate training and return to exercise
– Overweight and obesity
– Abnormal biomechanics
– Symptoms and signs described by you (the patient)
– Thorough assessment of foot, ankle and gait. This may include clinical examination and palpating the foot as the insertion sites of the plantar fascia are often tender to touch.
– In some cases, imaging may be required in order to rule out other differential diagnoses
Treating and preventing plantar fasciitis successfully requires correct determination of the cause of injury to the plantar fascia. Once this has been determined by a podiatrist, it is possible to develop an appropriate and individual treatment plan which targets the specific factors involved in each case. Thus, it is not a one size fits all treatment regime as this is often unsuccessful and commonly frustrating for patients who wish to seek relief from the pain and morbidity associated with plantar fasciitis.
One of the most successful treatment regimens for plantar fasciitis is the use of custom-made podiatric-approved orthotics. This allows podiatrists to treat the specific causes of injury and off load regions of the foot in order to allow it to heal and recover.
Similarly, advice on appropriate footwear to assist in this process is crucial. The amount of support and cushioning in different shoes can also be crucial in preventing injury recurrence.
Other options employed by our podiatrists in order to successfully treat this condition include; dry needling, foot and ankle exercises and/ or stretching, as well as advice on activity levels and alternatives.