Plantarfasciitis

Pathophysiology

The Plantar Fascia runs underneath each foot, stretching from the bone at the back of the ankle to out towards the toes. Plantar Fascia pain occurs in both athletic and non-athletic populations and although it is seen in all ages, is more common between 20-34 years old.

There are several risk factors which contribute to plantar heel pain:

  • Limited ankle movement
  • Being overweight
  • Running and work-related weight bearing activities
  • Long distance walking
  • Repeatedly getting in/out of vehicles

Symptoms

  • Pain on the bottom of the foot, often worse at the heel
  • Pain with weight-bearing e.g. standing and walking
  • Usually worst first thing in the morning on waking and improves with initial movement
  • Pain worse after a period of inactivity

Management

  • Activity modification and offloading e.g. avoiding prolonged standing or walking
  • Heel cups to reduce pressure
  • Ice rolling using a frozen water bottle
  • Pain relief
  • Physiotherapy including range of movement exercises and a graded strengthening programme

Investigations

  • Not generally indicated

Helpful Documents

Exercises to try:

PF

Calf Stretch Exercise

Standing with both hands shoulder width apart on a wall

Step one foot back behind the other

Push forwards into the wall with the front knee bent

Keep the back leg straight and heel flat on the floor

Hold for 30 seconds

PF

Plantar Fascia Loading

Standing on your bottom step, holding on to the handrail 

Place a rolled up towel or small paperback book underneath the toes

Slowly raise up onto your toes, then lower down below the step

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