Plantar Fasciitis

What is the plantar fascia?

This is a thick sheet of tissue on the sole of the foot which runs from the heel bone (calcaneus) to the bones in your forefoot (metatarsal heads). This strong tissue is important in maintaining the arch of your foot and can withstand significant loads.
The plantar fascia also has some connections to the Achilles tendon which is the tendon of your calf muscles.

Anatomy

Plantar Fasciitis is a painful process where there is inflammation and overuse damage to the plantar fascia where it attaches to the heel bone. The pain is typically worse in the morning especially the first few steps out of bed. It also flares up after prolonged periods standing or walking. The pain is located around the inside of the heel and can be reproduced by applying pressure to the area. X-Rays may sometimes show calcaneal spurs but these are NOT the cause of the heel pain but rather a result of the process causing the problem.

Treatment

Plantar fasciitis is usually a self limiting process that improves with time. This however, often takes several months. In the cases where simple measures including rest, change of foot wear and simple pain killer tablets have failed to make a difference the following measures are effective:

Physiotherapy to stretch the calf muscle complex which is the most effective method of reducing the stress in the plantar fascia.
Night splints to stretch the calf muscles and plantar fascia.
Use of gel insoles to cushion the heel bone.

The evidence supporting use of steroid injections is poor and given the risks we try and avoid this approach. In intractable cases which have failed to respond to good physiotherapy and footwear changes, surgery is an option that may be discussed with your treating surgeon.

Foot & Ankle

Hip Pains

Knee

Shoulder

Spine

Lower Back Pain

Paediatric Orthopaedics