Plantar Fasciitis

Author Mohammad Taleb

Sharp pain at the bottom of your foot? Pain at the heel? Pain with the first few steps in the morning? This could be a classic case of Plantar Fasciitis, a painful condition which affects the tissue that connects your heel to the base of the arch of your foot.[1]   

Plantar Fasciitis is irritation to the connective tissue caused by repetitive strain or tearing. It is exacerbated by an individual’s foot wear (such as wearing high heels), having tight calves, flat feet, being overweight or after standing for long periods on hard surfaces.[2]

This condition occurs in about 10% of the general population and is estimated to account for 10% of runner related injuries. Diagnosis by a Health Care Professional is sufficient & without the need for a scan by completing a physical assessment taking into consideration of the history reported by the patient.

Various studies have shown that there are a variety of different treatments that have been proven to be effective. The first of which is advice and education around encouraging patients to lose weight which will reduce the pressure on the Plantar Fascia. In addition, modifying high impact activities and icing the sole of your foot by rolling a water bottle under it has shown great results.[3]

From a Physiotherapy perspective, proven treatments include stretching the calf muscle and Plantar Fascia, taping the bottom of the foot using sports tape (low dye taping), using night splints or orthotics to adjust the foot position to reduce the pressure on the Plantar Fascia. I myself just had a patient who reported that the low dye taping technique provided them with instant support to their arch as soon as they stood up, and further support for a couple of days post treatment until the tape lost its integrity.

If these conservative treatment options fail, Shockwave Therapy has shown to be effective in treating Plantar Fasciitis, particularly  in chronic cases lasting longer than 6 months. Alternatively, corticosteroid injections are not recommended as repetitive injections can weaken the plantar fascia.[4] Finally as a last resort surgery may be considered if all other treatment modalities fail.

[1] Muth CC. Plantar Fasciitis. JAMA. 2017;318(4):400. doi:10.1001/jama.2017.5806

[2] Goff JD, Crawford R. Diagnosis and treatment of plantar fasciitis. Am Fam Physician. 2011 Sep 15;84(6):676-82. PMID: 21916393.

[3] Johnson RE, Haas K, Lindow K, Shields R. Plantar fasciitis: what is the diagnosis and treatment? Orthop Nurs. 2014 Jul-Aug;33(4):198-204: quiz 205-6. doi: 10.1097/NOR.0000000000000063. PMID: 25058723.

[4] Luffy L, Grosel J, Thomas R, So E. Plantar fasciitis: A review of treatments. JAAPA. 2018 Jan;31(1):20-24. doi: 10.1097/01.JAA.0000527695.76041.99. PMID: 29227320.