Feb 2016 13

Plantar fasciitis

By: Dave Wheeler

One of the most common injuries that I come across in my treatment room is plantar fasciitis.

The plantar fascia is, like all fascia, a form of connective tissue that covers the plantar surface (that is, the bottom) of your foot. It's thick & fibrous, and has a shockingly bad blood supply which means that if it gets damaged, it repairs REALLY slowly.


The cause of plantar fasciitis

All the anecdotal evidence is that plantar fasciitis is caused by overuse, though there is no scientific evidence to prove that. Those who get the condition tend to fall into 1 of 2 groups:

  1. Runners or joggers who suddenly up their mileage (plantar fasciitis is sometimes known as â€‹jogger's heel)
  2. People who do little or no exercise, but who maybe stand for long periods of time.

There seems to be some correlation between people who's feet roll inwards whilst walking or running to the incidence of plantar fasciitis.

There also seems to be some connection between plantar fasciitis and tight calf muscles - though one may not necessarily cause the other (they may both be caused by something else going on).


The signs of plantar fasciitis

People with plantar fasciitis will feel pain on the plantar surface (the underneath of the foot). Often, though not exclusively, this is on the heel.

Around 80% of people with heel pain (that is, pain on the bottom surface of the heel) will be suffering from plantar fasciitis. It's most common in people who are 40-60 years old.

If the plantar fascia has a rubbish blood supply, it's at its worst at the heel where the fascia covers the fat pad that covers the heel bone (or calcaneus). This means  that if you develop plantar fasciitis on the fat pad, then you're screwed, just rest up til it's gone.

The pain of plantar fasciitis (whether it's on the heel,  the instep, or on the bottom of the foot itself) is often worse after period of inactivity, for  example:

  • first thing in the morning
  • after sitting down for a while
  • when starting a walk or run

Often it'll  get better after a few minutes of walking or running. Though the pain may well come back with a vengeance some way into your stride.

Sometimes people with plantar fasciitis  will also get pain when pulling their toes up.


Curing plantar fasciitis

The  bad news is,  there's no cure.

The good news is, it gets better by itself if you're sensible.

If you carry on with your running or walking when you've got it then you'll make it worse. In severe cases, the plantar fascia can rupture, meaning a couple of years off activity!

Remember, crap blood supply = slowness to heal. If you carry on exercising on a foot that's got plantar fasciitis then it'll get worse quickly and take much longer to heal.

So the earlier you start being sensible, the quicker it'll heal.

What you can do:

  • Stop running / walking / any activity that causes impact on the affected foot.
  • Wear spongy insoles in your shoes & slippers - again, minimise the impact as much as possible. If it feels like you're walking on air, then you've got it right.
  • Stretch the calf muscle

Plantar fasciitis will often sort itself out within 6 months if you catch it early and are sensible. The longer you leave it and continue to act as if nothing is wrong, then the longer is can take to heal when you do start resting it - up to 2 years in severe cases.


A remedial massage therapist can also give you some limited treatment - though remember that they are limited and can only assist in the restorative process; massage treatments won't cure plantar fasciitis.

As ever, if you think I can help, give me a call.