Plantar Fasciitis Symptoms and Treatment
What is the plantar fascia and Plantar Fascitiis?
The plantar fascia is a thick tendinous structure underneath the foot. It attaches from the knuckles of the toes to the heel bone and holds up the arch.
Plantar Fasciitis is irritation of the plantar fascia at the point where the tendon inserts into the heel bone (marked with the red cross below). Although some people will suffer from chronic or recurrent plantar fasciitis for years, we believe that with the right treatment, plantar fasciitis should be healed within weeks to months. They key is identifying the root cause of the injury, which may be different for different people even though they have the same symptoms.
Symptoms of plantar fasciitis
Plantar fasciitis is easy to diagnose by its very specific symptoms:
Pain getting out of bed. If you’ve got plantar fasciitis the first few steps in the morning are agony. It might take a few minutes or a few hours to settle.
Point tenderness at the front of the heel bone (red cross above). People with plantar fasciitis typically have a tight sore arch of the foot and a particular point of tenderness at the front of the heel. If this is not where your pain is, your foot pain is not plantar fasciitis.
Pain after sitting down for a while. If you’ve been sitting or lying down for a time, the first few steps when you get up will be as bad as that first couple in the morning.
Increased pain when walking barefoot on hard surfaces.
Increased pain with increased loading. Whilst resting and not loading your foot will make it painful when you stand up, too much loading will also increase pain.
If this does not sound like your pain, you do not have plantar fasciitis. That said, other conditions can create foot pain. Some of the treatment suggestions below may still be useful for these conditions.
What causes plantar fasciitis?
Plantar fasciitis is more accurately plantar fasciosis. It is a biomechanical or overuse injury where the demand/ load places on the plantar fascia is more than it can give. It is essentially overworked.
The plantar fascia’s job is to support the arch of the foot (along with a few other foot muscles). The amount of work the plantar fascia has to do can increase; if the foot muscles are not working as a team, if there is a biomechanical or postural problem further up the body, or if the load placed on the fascia suddenly increases (e.g. increased body weight or time on your feet). If that increased demand remains for some time, the plantar fascia gets tired and will become irritated.
Plantar fasciitis treatment
Plantar fasciitis is more accurately plantar fasciosis as studies have shown that it is not an inflammatory condition but rather a degenerative condition. This means that anti-inflammatories such as Voltaren and ibuprofen are unlikely to help.
Degeneration is a scary word. If you have early-stage plantar fascia pain, don’t worry. If you have been battling this for some time, however, you are at risk of tearing the plantar fascia, so it is essential you identify and treat the underlying cause of the problem.
Short-term treatment Options
Treatments to improve plantar fasciitis in the short term are:
Release the arch of your foot with a hard ball or frozen water bottle. Part of the reason the plantar fascia becomes painful is that it is working too hard. Releasing the muscles underneath the foot can help decrease the pull on the point of irritation where the tendon attaches to the bone.
Do a morning stretch sitting on the side of the bed to lengthen the plantar fascia before you put your weight on it. During the night, the plantar fascia shortens. When we stand up first thing in the morning, the plantar fascia gets a rude shock and suddenly elongates as we load our entire body weight onto it. To stretch the bottom of your foot, gently pull your toes back and hold for 45 seconds.
Wear supportive shoes, over the counter orthotics or use tape to offload the plantar fascia. We must stress these are not long term solutions but can help to relieve pain initially. The plantar fascia is painful because it is working too hard, thus giving it some support via taping or supportive footwear can offload it enough to decrease your pain.
Calf stretches or using a roller to release the calf muscles.
Calf raises (with good technique).
For complete resolution of Plantar Fasciitis
To completely resolve plantar fasciitis, the underlying cause needs to be identified. Sometimes it will be because of poor footwear or a sudden increase in loading, for example, if you suddenly increased your exercise regime exercise.
Think about any changes that may have occurred in the months before the injury. It might be foot-related, e.g. new shoes or a new exercise class or regime, or it might be because of something that has created a change further up your body, e.g. a new car, caring for a new baby or a different workstation set-up. If you’ve identified any changes, change them back and monitor the effect on your plantar fasciitis.
If your plantar fasciitis is taking a long time to heal or if you’re having difficulty identifying potential contributors, make an appointment for some professional advice. With the right management plan, plantar fasciitis can be significantly improved within days and healed within a matter of weeks to months.
(And just so we’re clear, we don’t believe that requiring orthotics for the rest of your life is the same as healing plantar fasciitis. Orthotics or insoles are a great short term strategy for symptom management, but for most cases, we should be able to train and strengthen the feet and body so that orthotics aren’t required long-term).
My foot pain doesn’t sound like plantar fasciitis, what should I do?
Plantar fasciitis is a particular condition with particular symptoms. Many other conditions can be equally debilitating such as calcaneal nerve entrapment, fat pad irritation, and metatarsalgia. Like plantar fasciitis, these conditions are also often a result of poor foot function, so releasing the arch, rolling and stretching the calf and using orthotics can also provide relief in these situations. If these quick fixes aren’t helping, we recommend you make an appointment so we can accurately assess and diagnose your particular pain and design you a personalised rehabilitation plan to get you back to life.