Plantar fasciitis is one of the most common causes of foot pain, often affecting the heel. This condition can make everyday activities like walking and standing uncomfortable. In this guide, we’ll explore what plantar fasciitis is, what causes it, and how you can manage and treat the condition for long-term relief.
Where Does Plantar Fasciitis Occur?
Most people with plantar fasciitis experience sharp pain on the sole/ bottom of their foot at the medial (inside) aspect of their heel. It most commonly occurs on only one side but can present bilaterally.
What Is Plantar Fasciitis?
Plantar fasciitis is a breakdown of plantar fascia tissue, which is a strong ligament on the sole of your foot that supports the medial arch. When your foot is too stiff, not well supported dynamically (by your neuromuscular system), or being over-loaded due to weakness in other areas of your leg, the plantar fascia is forced to absorb more load than it can handle and, as a result, becomes irritated and inflamed.
When Is Plantar Fasciitis Most Painful?
Plantar fasciitis tends to be most painful in the morning when first loading your feet getting out bed, or after periods of prolonged rest. It can also be aggravated by impact activities such as walking, running, and jumping – although in some cases the foot can “warm-up” for a period that will be less painful, then pain can return with prolonged activity/ impact.
Why Does Plantar Fasciitis Happen?
Several factors can contribute to the development of plantar fasciitis, including:
- Poor foot mechanics/ mobility (in the toes and the arch of the foot)
- Weak muscles in the foot, calf, and hip
- Poor stability/ balance
- Excess resting tension +/- decreased muscle length in the calf particularly
- Excess body weight
- Can develop slowly over time or be related to an acute injury
Is Flat Feet the Cause of My Plantar Fasciitis?
Flat feet or “pes planus” is not a cause of plantar fasciitis alone. If you have great foot, calf, and hip strength, flexibility, muscle tension, and stability, you are unlikely to develop plantar fasciitis just because you have flat feet. Flat feet are not symptoms that have to be managed if there are no associated symptoms.
However, if you do not have good foot support dynamically then the arch height may play a role in increasing symptoms.
How Can I Treat Plantar Fasciitis?
Comprehensive management of plantar fasciitis should include:
- Professional assessment and diagnosis to ensure correct management
- Generally, imaging is not required, but your clinician may choose to pursue this option if they feel they need to rule out other possible causes
- Guided exercise therapy to address areas of weakness/ inflexibility/excess tension/ poor stability
Treatment Options for Plantar Fasciitis
Symptom management can include:
- Temporarily avoiding barefoot walking
- Massage therapy
- Dry needling/ acupuncture
- Joint mobilisation
- Taping/ Orthotics
- Shockwave therapy
- Pain medications
- Splinting
- Corticosteroid injections
- Surgery