What is it?

The plantar fascia is a thick supportive band of connective tissue on the sole of your foot. It can become overloaded, over stretched or compressed which leads to inflammation and thickening of the fascia causing pain when walking, standing, queuing and generally weight bearing on the affected foot.

Who gets it?

Females are slightly more at risk than males. Other risk factors include being overweight (BMI > 30), tight calf muscles at the back of your leg, poor balance/strength at the ankle and lower limb and poor foot biomechanics. Also employment where you are on your feet for more than six hours greatly increases your risk. Plantar fasciitis has been known as “Policemans heel” in the past however, should also be called nurses’ heel and security guards heel as these jobs often experience the problem also.

What can I do about it?

There are lots of simple self care techniques can be adopted. Such as

  • Weight loss
  • Calf stretches
  • Foam roller
  • Sole of foot stretches
  • Simple heel gel cups to help with shock absorption
  • Insoles for your shoes. Especially appropriate if the arch on the inside of your foot is changing shape.
  • Modifying work if possible. More frequent breaks from standing/walking and wearing lighter softer shoes for comfort.
  • Strengthening exercises for the calf musculature and foot.

How can Physiotherapy help?

Here at Fay Pedler Physiotherapy clinic we will first undertake an assessment including full medical history including aggravating and easing factors, any previous problems, general health and other conditions that may pre-dispose to plantar fasciitis. A physical examination will determine any loss of knee, ankle or foot range of movement, test for signs of nerve involvement, stress the plantar fascia to recreate your symptoms and accurately diagnose.

Next step would be to ensure you are performing all possible self management strategies correctly and progressing as appropriate before discussing further interventions we can offer including:

  • Calf and foot massage which can be really useful if you have particular muscle tender points or tight areas in your calf musculature.
  • Acupuncture. Although uncomfortable, we have many patients over the years who have really benefitted from this treatment.
  • Shockwave therapy. Recent National Institute of Clinical Excellence (NICE) guidelines have suggested benefit to patients with plantar fasciitis. This technique uses pressurised sound waves to increase blood flow and numb the painful area. As pain subsides patients can stretch and strengthen more freely.
  • Arranging onward referral if necessary. In the unlikely event that symptoms do not settle following the aforementioned options we can arrange with you and your GP the appropriate pathway for onward care. We have a vast experience of the local referral pathways for the region and can discuss with your GP regarding further assessment and opinion from Orthopaedic consultants including imaging and possibly steroid injections.