What is plantar fasciitis?

Plantar Fasciitis

Plantar fasciitis is the medical term for thickening of the band of tissue known as the plantar fascia, located underneath the heel of the foot. It is generally characterized by soreness and tenderness underneath the heel and sometimes moving into the arch of the foot.

Risk Factors

  • Typically seen in patients between the age of 40 – 60
  • More common in females than males
  • Being flat-footed or high arched
  • Tightness in the back of the leg
  • Rapid change in activity levels
  • Abnormal gait
  • BMI
  • Poor footwear
  • Occupation

Signs & Symptoms

Most acute pain is in the morning or directly after long periods of rest and may relieve slightly over time
Pain with prolonged standing or walking
Pain can be directly palpated underneath the heel and along the arch of the foot
Sharp pain on first step moving into aching by the end of the day

Diagnosis

In most cases clinical assessment by your podiatrist can lead to diagnosis of plantar fasciitis, however in some cases imaging may be needed. This may include either an x-ray or ultrasound to check the plantar fascia band and/or the calcaneus (heel bone).

Differential Diagnosis

Soft tissue: fat pad atrophy, Achilles tendinopathy, post tibial tendon dysfunction (PTTD), plantar fascia rupture, bursitis

Skeletal: Heel spurs, stress fracture, arthritic changes, apophysitis

Neurological: Tarsal tunnel syndrome, neuropathy, nerve entrapment

Treatment

Conservative treatment will include; a home exercise plan for stretching the posterior lower limb muscles, icing the affected area of the heel, rolling a ball underneath the foot and manual therapy, strapping and padding conducted by your podiatrist. Orthotic treatment is also used in conjunction with manual therapy.

Other more invasive treatments may be needed if there is no resolve including but not limited to;

  • ESWT (shockwave therapy)
  • Corticosteroid injection
  • Laser therapy
  • Surgery