What Is Plantar Fasciitis?
Plantar fasciitis is a chronic degeneration of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain.
Why the pain follows rest rather than activity
Plantar fasciitis behaves unlike most injuries, which hurt more the more you do. Here the fascia tightens while you are off your feet, so the first steps after sleeping or after sitting stretch it suddenly, which is where the sharp pain comes from. A few minutes of walking loosens it and the pain settles, then returns after the next rest, or after a long day standing.
What Causes Plantar Fasciitis?
The most common cause of plantar fasciosis relates to a faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fasciosis.
Foot structure
People who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fasciosis.
Footwear and standing surfaces
Wearing non-supportive footwear on hard, flat surfaces puts an abnormal strain on the plantar fascia and can also lead to plantar fasciosis. This is particularly evident when one’s job requires long hours on the feet.
Body weight, and a change in load
Obesity may also contribute to plantar fasciosis.
Symptoms to Look Out For
The symptoms of plantar fasciitis are:
- Pain in the bottom of the heel.
- Pain that is usually worse upon arising.
- Pain that increases over a period of months.
People with plantar fasciosis often describe the pain as worse when they get up in the morning or after they’ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.
How Is Plantar Fasciitis Diagnosed?
To arrive at a diagnosis, Ozan Amir will obtain your medical history and examine your foot. Throughout this process Ozan rules out all the possible causes for your heel pain other than plantar fasciitis.
In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
Conservative Treatment Options
Initially see your local podiatrist, who may add one or more of these treatment approaches:
| Treatment | What it does |
|---|---|
| Padding and strapping | Placing pads in the shoe softens the impact of walking. Strapping helps support the foot and reduce strain on the fascia. |
| Orthotic devices | Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis. |
| Injection therapy | In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain. |
| Removable walking cast | A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal. |
| Night splint | Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some patients. |
| Physical therapy | Exercises and other physical therapy measures may be used to help provide relief. |
What you can do yourself
Alongside treatment, what you do between appointments matters, because the fascia is loaded every time you stand up.
- Wear supportive shoes indoors as well as out, rather than going barefoot on hard floors.
- Stretch the calf and the sole before the first steps of the day, not after them.
- Change the surface or reduce the standing time where a job allows it.
- Keep going with the plan once the pain eases, because the pain settles before the tissue does.
When Symptoms Persist
Although most patients with plantar fasciosis respond to non-surgical treatment, a small percentage of patients may require surgery. If, after several months of non-surgical treatment, you continue to have heel pain, surgery will be considered. Ozan Amir will discuss the surgical options with you and determine which approach would be most beneficial for you.
Between conservative care and surgery, Manly Foot Clinic delivers injection therapy and shockwave therapy on site, and either may be considered for heel pain that has not settled. Manly Foot Clinic has not published how long plantar fasciitis takes to resolve or how often each treatment succeeds, so this page states neither.
Plantar Fasciitis in Children and Teenagers
Heel pain in a child between roughly eight and fourteen years of age is more often calcaneal apophysitis, also known as Sever’s disease, an irritation of the growth plate at the back of the heel, than plantar fasciitis. It is a different condition and is assessed on its own terms, which is why heel pain in a growing child should be examined rather than assumed.
Plantar Fasciitis FAQs
People with plantar fasciosis often describe the pain as worse when they get up in the morning or after they’ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because walking stretches the fascia.
Heel pain is the symptom and plantar fasciitis is its commonest cause. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely, a cyst, which is why it is important to have heel pain properly diagnosed.
Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
Most patients with plantar fasciosis respond to non-surgical treatment. Manly Foot Clinic has not published a typical recovery time, so this page does not state one; your podiatrist will give you a plan and a review date at your assessment.
No, you can book directly without a referral. If you’d like, we’ll send a short report to your GP after your appointment so your foot care stays part of your overall health record. If your appointment is through a Medicare care plan, DVA or another funded program, you will need a referral, so check with us when you book.
Serving Manly and the Northern Beaches.
Manly Foot Clinic is at Shop 3/3 Corrie Rd, North Manly, NSW 2100, and treats plantar fasciitis for patients from Manly, Dee Why, Brookvale, Freshwater and Balgowlah. The clinic is open Monday to Friday from 8:30am to 5:30pm and Saturday from 8:00am to 2:00pm.