What is it?

Plantar fasciitis is a common condition that is characterised by small tears of the plantar fascia. The plantar fascia is a strong ligament that supports the foot which is a thick fibrous band which attaches to the heel (called the calcaneus) and then runs forwards to the forefoot and attaches to the base of the toes where they attach to the surrounding tissue.

Mechanism of Injury

It usually occurs when there is overloading of the band that causes micro-tears and secondary degenerative changes in fascia. 

It is most commonly seen in males, in particular the 30-50 age group. Plantar fasciitis may occur in sports people especially in endurance activities, the obese, people with tight calves, flat arches of the foot, wearing improper shoes and people who spend many hours standing or walking on their feet.

Common Management Techniques

Conservative Management

• Conservative Management

• Rest – avoid exacerbating exercise, reduction in activity

• Dencorub/deep heat (heating creams) – use on the affected area first thing in the morning

• Correct and well-fitting shoes

• Prescription of Functional Foot Orthoses which provide arch support and influence lower limb biomechanics

• Night Splints

• Strapping and taping – applied professionally and last for up to 4 days

• Icing after activity

• Referral to a doctor for anti-inflammatory medication or a Corticosteroid injection

Surgical management is sometimes required in patients who continue to have symptoms regardless of many treatments.

Prognosis

Most people will recover to full function after a combination of medications, physiotherapy, and steroid injections. Plantar fasciitis is considered a self-limiting condition and the time that it takes for the condition or symptoms to resolve is highly variable. Prolonged symptoms are usually associated with patients with symptoms on both feet, obese patients or patients who had symptoms longer than 6 months before seeking medical attention.