Plantar Fasciitis
Most people with plantar fasciitis often experience difficulty in the morning when trying to get out of bed. This condition causes sharp heel pain; it is often most intense when taking the first steps upon waking up.
The plantar fascia is a thick band of connective tissue stretching from the heel down towards the base of the toes. It plays a major role in supporting the arch, absorbing shock, and adding a spring to your step.
Excessive strain—whether from running and dancing, prolonged standing on hard surfaces, wearing improper footwear, or even carrying extra weight—can cause irritation and small tears within the plantar fascia. Over time, this damage can cause stiffness and discomfort, most commonly felt in the base of the heel.
Symptoms of Plantar Fasciitis
Pain at the base of the foot close to or on the heel is usually the primary symptom of plantar fasciitis. For some, this discomfort can feel like a sharp, stabbing sensation, while others describe it as similar to pressing on a deep bruise.
Pain is often at its worst when you first step out of bed in the morning or following prolonged sitting. This happens because the plantar fascia shortens and tightens when the foot is at rest. For example, when sleeping with the feet facing downward or sitting in a relaxed position.
While the pain usually eases after 5 to 10 minutes of movement, it can worsen throughout the day. This is especially the case with running, prolonged standing, or other activities that put stress on the foot.
Causes
One of the primary causes of plantar fasciitis is tightness in the gastrocnemius, which is among the major calf muscles. When this muscle is too tight, bending the foot and lifting the toes toward the shin becomes difficult.
Tightness in the Achilles tendon—the band of tissue connecting the calf muscles and the heel bone—is also a common culprit for plantar fasciitis.
Additional factors that may increase the risk of developing the condition include:
- Repeated impact from activities like running, dancing, or high-impact sports
- A sudden increase in physical activity
- Excess body weight (obesity)
- High arches
Diagnosis
Doctors normally diagnose plantar fasciitis through a physical examination and assessment of symptoms and activity levels. An X-ray may be performed to rule out other conditions. These include heel spurs (calcium deposits that form between the heel and arch), stress fractures, or cysts.
However, an X-ray cannot confirm plantar fasciitis. An MRI may be used in cases where the diagnosis is uncertain or if symptoms persist for more than six months. MRI provides a definitive diagnosis by revealing any thickness or tear within the plantar fascia.
Treatment for Plantar Fasciitis
The initial plantar fasciitis treatment is typically conservative, focusing on simple lifestyle adjustments. Stretching exercises for the calf, foot, and Achilles tendon can help relieve tension. On the other hand, wearing supportive shoes and not walking barefoot can reduce strain on the plantar fascia, leading to less pain.
Reducing or modifying high-impact activities may also be recommended. This can include switching from running on pavement to softer surfaces like trails or treadmills. Weight loss can also alleviate pressure on the feet for individuals carrying excess weight. If proper footwear does not provide enough relief, over-the-counter or customised orthotics may offer additional support.
Night splints, which keep the foot at a 90-degree angle, can help stretch the plantar fascia when sleeping. These splints come in various styles and materials. For those who find them uncomfortable to wear overnight, using them while relaxing—such as watching TV—can still be beneficial.
Generally, plantar fasciitis is not a permanent condition. Hence, staying active will not cause the plantar fascia to tear completely or lead to long-term complications. Conservative treatments sometimes do not provide relief, and pain begins to interfere with daily life. In such cases, the doctor may administer a cortisone injection to reduce inflammation. This injection provides relief for 3 to 6 months, often allowing the condition to heal naturally.
Additional physical therapy treatments may also be considered, including:
- Dry needling. Similar to acupuncture, this procedure involves inserting thin needles into the skin to ease muscle pain.
- Joint mobilisation. A hands-on physical therapy technique that helps improve movement and reduce discomfort.
- Platelet-rich plasma (PRP) injections. A procedure that involves injecting a patient’s concentrated blood platelets into the injured tissue to stimulate healing.
- Shockwave therapy. A non-invasive treatment that delivers shock waves to the affected area to promote tissue repair and pain relief.
In rare cases, surgery may be an option for individuals who experience persistent, severe plantar fasciitis that significantly impacts their quality of life. If a patient suffers from recurring, debilitating symptoms, addressing the root cause is essential. In many cases, surgically lengthening an extremely tight gastrocnemius (calf muscle) may provide lasting relief.
Summary
Plantar fasciitis is the leading cause of heel pain, but it can be effectively managed with the right care. If your heel or foot pain doesn’t improve within a week, it’s important to consult a healthcare provider. They can recommend treatments to relieve pain and inflammation, helping you heal faster.
While taking a break from your favourite activities can be frustrating, allowing your foot to recover fully is essential. Rushing back too soon may lead to re-injury and prolong the healing process.
Contact or visit us to learn more about the conditions and treatment options to take the first step toward lasting relief.