Outpatient Physiotherapy
Plantar Fasciitis This leaflet provides information, answers and self-help strategies regarding your plantar fasciitis.
FREQUENTLY ASKED QUESTIONS What is plantar fasciitis? What are the treatment options? Plantar fasciitis is a condition which causes pain in the heel and foot. It is a condition that can affect one or both feet, and not always at the same time. The plantar fascia is a thick ligament-like structure which supports the bottom of our feet. A one-off injury or repetitive overload can cause this condition.
What are the symptoms? Common complaints of plantar fasciitis are often sharp pain on standing after a period of sitting and the first few steps in the morning, which gradually eases after a short period of walking. Prolonged walking may cause the foot to ache and resting eases the pain.
What are the causes? Sudden change in walking, running or standing routine. Poor footwear. Being overweight. Poor muscle flexibility. Certain foot postures can be more prone to developing plantar fasciitis, such as high arched or flatter feet.
You can often treat plantar fasciitis yourself with exercise and selfmanagement techniques. It can take a couple of weeks to notice improvements in the pain and it can sometimes be painful to begin, but perseverance is the key.
Positions of rest An important component of treating plantar fasciitis is to avoid positions where your foot is pointing away from you for too long. Whilst sitting on an office or dining room chair, keep your feet flat on the floor directly underbeath you. Whilst relaxing at home, try putting your feet on the arm rest of the sofa.
WHAT CAN I DO? Stretching Initially this can be uncomfortable but you should aim to stretch as regularly as possible. Each stretch should be held for 20 seconds and repeated regularly throughout the day.
Calf stretch Point both feet forwards (affected leg at the back). Keep the back foot heel in contact with the floor. Lunge forwards onto the front leg until you feel a stretch in the lower part of your back leg.
Plantar fascia stretch Using the corner of the floor or back of a door Wedge your foot and big toe in the corner Slowly push your foot towards the ground forcing your big toe upwards.
Strengthening exercises – heel raises with toe extension Strengthening exercises for the plantar fascia can increase the strength and fitness of the feet, to help reduce pain and improve function. Exercises should be completed in a slow and controlled motion, for 12 repetitions, repeated three times daily. Stand on a rolled-up towel with your toes pushed upwards. Slowly lift up onto your toes. Slowly lower back down to the floor. You can progress the strengthening exercises by increasing the repetitions and frequency of the exercise as well as increasing the intensity by adding weight. For example, wearing a rucksack with a few books inside. Continued overleaf >>>
WHAT CAN I DO? Footwear/orthotics
Painkillers
Orthotics help support the sole of your foot and prevent you over stretching the foot while you are walking. Try to wear supportive shoes or trainers and avoid flip flops and excessively flat-soled shoes.
Simple painkillers or anti-inflammatory medication can help to reduce the pain in the early stages. (Always check with your GP or pharmacist before taking any new medication)
I have tried these treatments before. What else can I do? Plantar fasciitis can take up to 12 months to improve, but with implementing some of the exercises and habits mentioned previously, your symptoms should settle within three to four months. Should your pain continue, you should seek medical advice as you may need: Physiotherapy. This will often involve a specific stretching programme and advice on footwear. Physiotherapy will also explore the causation of the pain, ensuring your foot shape or biomechanical factors are not hindering your recovery. Injection. Very occasionally where the plantar fascia attaches onto our heel bone, this can become inflamed. An injection can helped to settle down the inflammation and pain but still requires you to stretch regularly.
Extracorporeal shockwave therapy (ESWT). Shockwave therapy is a new treatment that can aid recovery of plantar fasciitis when symptoms are resistant to exercise, footwear advice and pain relief. Customised footwear. Some people require custom-made orthotics to help with their foot posture, or soft heel inserts to offload the painful area. Night splints. These prevent your feet and plantar fascia from tightening while you sleep, hopefully reducing the pain you experience in the morning.
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