Plantar fasciitis is a degenerative condition of the foot, characterised by changes in the collagen fibres in the plantar fascia, without inflammatory signs. These degenerative changes are generally due to overuse or repetitive microtraumas, with stretching of the plantar fascia which exceed its ability to recover. Being one of the most common foot pathologies, accounting for 10% of injuries in runners, it tends to affect those in the range of 40-60 years old.
Patients often describe a stabbing pain on the base of the foot of the heel when taking the first steps in the morning. Many also experience tightness in the calf muscle and Achilles tendon.
Treatment for plantar fasciitis is commonly conservative, consisting of hands-on therapy, taping, and lower limb stretching and strengthening. Advice may also be given to stretch the plantar fascia for symptomatic relief, as well as the use of cushioned orthotics. Patients must be made aware that symptoms can last for weeks or months despite undergoing a well planned treatment programme. Should conservative rehabilitation fail, then the use of extracorporeal shockwave therapy or platelet-rich plasma injections may be considered.
Once symptoms have subsided then it is vital the intrinsic muscles of the foot are continually exercised to maintain strength, stability and agility.