admin@thefeetpeople.com.au

(07) 3356 3579

BOOK NOW
BOOK NOW

Jump to section

What is plantar fasciitis?
Causes and risk factors
Symptoms
Diagnosis
Treatment
Ignoring plantar fasciitis
Prevention
FAQs

Plantar fasciitis heel pain is one of the top conditions seen and treated by our podiatrists. As such, we’ve developed extensive evidence-based processes paired with gold-standard techniques and technologies to relieve your heel pain and reduce the risk of it returning in the future.

What Is Plantar Fasciitis?

You have a thick band of connective tissue at the bottom of your foot called the plantar fascia. It starts from your heel and extends to your toes in the shape of a fan. The plantar fascia is very important for healthy, pain-free foot movement, helping to stabilise and support your foot through any activities you do. When it becomes overloaded, the plantar fascia can become injured. That’s when pain and inflammation start, which is your body’s way of letting you know something is wrong. When you have an injured and sore plantar fascia, this is known as plantar fasciitis.  

Our podiatrists often see this injury after something changes in a person’s daily habits, activities or training regime. Plantar fasciitis is chronic (long-lasting), as the plantar fascia has to repeatedly and constantly deal with a load that it cannot manage from your daily activities.

Are heel spurs the same as plantar fasciitis?

It is not uncommon for heel spurs to occur at the same time as plantar fasciitis due to the stress and strain the heel bone is being placed under. Hence, many people often think that heel spurs must be the cause of their heel pain, or even that ‘plantar fasciitis’ and ‘heel spurs’ are the same thing. This is actually not the case! As confirmed by research, most heel spurs are asymptomatic and don’t cause pain in the plantar fascia tissue. Instead, it’s a damaged fascia that’s the cause of the pain.

Heel spurs being the cause of heel pain is one of the top heel pain myths we hear - you can read our list of heel pain myths and the truth about them here.

Causes And Risk Factors Of Plantar Fasciitis

As mentioned above, the most common cause and risk factor for plantar fasciitis is a change in how you load your foot - in a way that leaves it overloaded.

When repetitive, high loads are placed on the heel bone and the connecting soft tissues and structures, they are constantly fatigued. They get tired! And overworked. This result means their ability to absorb the excessive shock forces plummets, leading to inflammation and injury (plantar fasciitis).

Your risk of developing plantar fasciitis is often a combination of the following factors: 

• Overuse and overtraining 
  
• Wearing thongs or slip-ons for prolonged periods, especially after wearing supportive and comfortable footwear all winter
  
• Lots of time spent barefoot, especially over hard surfaces
  
• Wearing unsupportive (or otherwise inadequate) shoes when you’re being active
  
• Not replacing worn-out shoes, as they can no longer do their job of protecting and supporting your feet well anymore
  
• Not having enough strength, mobility and flexibility in the feet and legs
  
• Muscle imbalances and dysfunction
  
• Having rigid feet with poor mobility and flexibility that are inadequate to absorb shock (and not doing anything to support them better)
  
• Overpronation of the ankle and feet (when your foot rolls inward excessively)
  
• Having a leg length difference 
  
• Abnormal walking and running patterns that place extra stress on the heel bone and ligaments
  
• Weight gain and a sedentary lifestyle, which puts extra pressure on your feet and tissues, tipping them past the ‘overloading’ point
  
• Jobs or hobbies that involve standing on your feet for prolonged periods
  
• Age. Unfortunately, the older you become, the less elastic your tissues become
  

Symptoms Of Plantar Fasciitis

Plantar fasciitis symptoms can be quite debilitating, especially as it continues or worsens. The pain is typically localised to the heels, although it may radiate into the arch. You feel the most pain and discomfort when you take your first steps after waking in the morning or after standing after putting your feet up to rest for a while in the evening. 

Other symptoms of plantar fasciitis heel pain can include: 

• Pain, swelling and tenderness over the heel bone
  
• Pain that can be dull, sharp, intermittent and may feel like your heel is "bruised"
  
• You may struggle to or be unable to bear weight for your first few steps as you are getting out of bed 
  
• Your pain may worsen when you first start an activity e.g. running, hopping or jumping, and then may gradually improve as you warm up.
  
• Struggling to be barefoot, as it worsens your symptoms
  
• Arch stiffness and tightness
  

Diagnosing Plantar Fasciitis 

The signs and symptoms of plantar fasciitis closely resemble those of other causes of heel pain, so it's important to get a correct diagnosis from experienced podiatrists who are familiar with the condition so that you get the right treatment.To diagnose the cause of your heel pain, we start with a complete physical assessment of the area. This includes evaluating your foot posture, muscle strength and imbalances, joint flexibility testing, checking your gait via video gait analysis, and further specialised assessments as needed based on the results we find. 

In some cases, ultrasound imaging may be used to confirm the diagnosis or to assess the extent of the injury's damage. This tends to only be in cases where we suspect you have multiple injuries at once, or your pain is particularly severe, and we suspect there may be a significant tear in your plantar fascia that we’ll need to offload and closely monitor.

Treatment For Plantar Fasciitis

Plantar fasciitis is one of the most common conditions that our podiatrists see in our Brisbane CBD and Newmarket clinics.

When treating plantar fasciitis, we often suggest a personalised combination of the following treatments to allow you to achieve the fastest and most effective recovery.

• Custom-prescribed foot orthotics may be recommended to help ensure your training routine is minimally impacted, whilst allowing your injury to heal. Orthotics are an important part of recovering from plantar fasciitis because they modify the forces and load that your feet and heels are exposed to, meaning the injury gets better, not worse. Continuing to wear your orthotics when exercising or training after you have completely recovered from your plantar fasciitis injury also means that you reduce the likelihood of the problem recurring.
  
• Foot and ankle strapping to help temporarily relieve the strain from the plantar fascia while you stay active.
  
• Shockwave therapy is an effective and fantastic treatment that accelerates the healing process when it comes to plantar fasciitis. When the shockwave handle piece touches the foot, it emits high-energy acoustic pulses deep into the injured area. This stimulates collagen and new blood vessel formation, increases the blood flow, helps break down unhelpful calcium build-ups, and reduces pain. Shockwave has been shown to be a “top three” treatment adjunct in plantar fasciitis, according to studies.
  
• MLS laser therapy is a proven, painless and safe way to help treat plantar fasciitis. It helps relieve pain, reduce inflammation, and support soft tissue repair.
  
• The RICE protocol consists of rest, ice, compression, and elevation. This is a great way to start your recovery before you’re able to get in to see your podiatrist.
  
• Strengthening and stretching exercises to address any muscle imbalances that cause the injury so it reduces the likelihood of it recurring in the future, as well as helping with your rehabilitation
  
• Adapt and modify your training program to help prevent (or reduce the likelihood) of over-training and overloading the plantar fascia
  
• Supportive footwear with cushioning soles. We can give you recommendations on the best shoes based on the types of activities you do on a daily basis, as well as your foot type and gait characteristics. 
  
• Dry needling of the surrounding soft tissue structures to release muscle tension by targeting trigger points in the feet and legs.
  
• If needed, short-term use of anti-inflammatory medication to give you temporary relief until some healing has occurred.
  
• Foot mobilisation to help mobilise the joints and bones of the foot and ankle to address stiffness and dysfunction, supporting healing, repair and future injury prevention.
  

Your pain levels and symptoms are likely to improve in a few days or weeks simply by resting, but this doesn’t stop the problem from returning once you start being active and spending whole days on your feet again. This is why a comprehensive treatment plan is needed that includes stretching and strengthening the muscles around the feet and legs, so the problem doesn’t keep returning and troubling you on and off for years.

Treating Plantar Fasciitis At Home

While you may not be able to “fix” plantar fasciitis to get long-term relief at home, there are definitely things you can start doing at home today to support your recovery and help bring relief.

1. Before you leave bed in the morning and take your first steps, write the alphabet with your feet. This will warm up stiff joints and tissues before you place your entire body weight on top of them.
   
2. Alternate daily activity levels, completing more intense activities one day followed by lower impact ones, such as cycling or swimming. This will help you to stay active more comfortably, while you rehabilitate your injury. Remember, if the injury becomes too severe, you may have to be temporarily immobilised in a moon boot or air walker.
   
3. Avoid being barefoot or in thongs. This is when your plantar fascia has to work the hardest. 
   
4. Before getting out of bed, loop a towel or something similar around the ball of your foot and stretch your forefoot gently towards you. This should feel tight but not painful. Hold for 30 seconds, the rest. Repeat three times. This will help give your fascia a gentle stretch and ease the immediate stress when you stand.
   
5. Keep your feet supported in good shoes both indoors and outdoors while recovering from plantar fasciitis pain. Ideally, this will involve a good sports shoe.
   
6. If your heels feel swollen and painful, you can use ice applied through a tea towel for 15 minutes at a time to help reduce the symptoms. If this doesn’t provide enough relief, you may opt for some non-steroidal anti-inflammatory medication (NSAIDs), taken as directed on the packet.
   

Exercises you can try at home

Strength exercise - Calf raises with a twist.

• If needed, stand next to a chair or bench for balance
  
• Place a rolled-up towel underneath your toes so they are lifted off the ground, making sure you keep the ball of your foot on the ground
  
• Slowly raise both feet off the ground (going onto the ball of your foot), to as high as you can manage 
  
• Slowly lower yourself back to the ground over 3 -4 seconds.
  
• Start with 2 x 20 repetitions, as this becomes easier, increase repetitions, and then move to single leg. 
  

Self massage

• This exercise is done best sitting down with your feet on the floor.  
  
• You can place a smooth trigger point ball or frozen water bottle underneath your arch. 
  
• Slowly massage your arch out using your seated body weight within tolerable limits. 
  
• Please keep the discomfort under 4/10 pain-wise. If it is more painful than that, reduce the force you apply to your foot.
  
• We also recommend avoiding using the spiked trigger point ball as the arches of the feet are quite sensitive, making this very uncomfortable.
  

What happens if I ignore my plantar fasciitis 

Plantar fasciitis is not an injury where you can ignore the pain until it gets better. The longer you leave it untreated, the longer the recovery period. Without making any changes to your routine, the pain and injury will continue to get worse until you end up possibly tearing or rupturing the plantar fascia. If this happens, you'll generally require extended periods in a moon boot. 

Prevention

You shouldn't wait to experience pain before making changes to your lifestyle that would help prevent plantar fasciitis. Here are several simple preventative measures you can implement to help reduce your risk of developing this injury.

• Get the right advice regarding what footwear you should be wearing
  
• Reduce the time you spend barefoot and in thongs 
  
• Continually strengthen and condition your lower leg muscles by completing several podiatrist-recommended exercises.
  
• Get a podiatrist to analyse your movement patterns and footwear to ensure they are functioning correctly.
  
• Warm up and stretch before engaging in sports or strenuous exercise
  
• Start or increase training slowly by gradually increasing time and intensity
  
• Regularly stretch and maintain mobility and strength of the muscles of your lower limbs with podiatrist-recommended exercises.

FAQs