Plantar Fasciitis

Plantar fasciitis is a progressive degenerative condition affecting the thick band of tissue on the bottom of the foot. It is the most common foot pathology, accounting for 10% of running injuries, with a peak age onset between 40-60 years old. Microtears appear in the plantar fascia, and the condition is not inflammatory. It is thought to arise from overuse or repetitive microtraumas within the plantar fascia.

Many experience debilitating heel pain in the mornings, and on walking any prolongued distance. Tightness in the calf and Achilles tendon is often reported. Risk factors for developing the condition include a leg length difference, ankle and foot dysfunction affecting gait, and being overweight.

Treatment for plantar fasciitis is usually conservative, and includes exercise therapy, taping, and calf and plantar fascia stretching. Symptoms of plantar fasciitis can last for weeks or months despite adherence to a rehabilitation programme. Evidence states that local plantar fascia stretching is useful for reducing pain in the short-term. Mobilisation of the soft tissues of the plantar arch has also shown to be effective in reducing pain. Should this approach fail, then other techniques such as extra-corporeal shockwave therapy or platelet-rich plasma injections can be used. Should there be no improvement after 12 months, then surgery may be offered.

Prevention is often better than cure, and strengthening of the intrinsic muscles of the foot has shown to be effective for ankle, foot and plantar arch stability. Maintaining a good level of flexibility has also shown to be of benefit, and a comprehensive stretching routine should be an integral part of your training plan.

Canosa-Carro, L. et al. (2022). Current understanding of the diagnosis and management of the tendinopathy: An update from the lab to the clinical practice. Disease-a Month. 10: 1013-1016.