What is plantar fasciitis and how can I treat it?

Plantar fasciitis is one of the most common causes of heel pain and typically affects those aged in their 50s and 60s.

The painful, stabbing feeling that accompanies the condition is caused by inflammation of the plantar fascia on the sole of your feet. The plantar fascia is a double layered fibrous tissue on the plantar (sole) side of your foot that connects from your heel bone to the base of your toes.

It plays an important role in maintaining the integrity of the arch of our feet and is can affect everything from our feet to our ankles, knees and lower legs.

As such, the causes of plantar fasciitis can be many and may include knee, ankle and hip injuries and muscle hypertonia (tight calves and hamstrings). Poorly fitted shoes that don’t support the feet, or compress them too much, can also cause plantar fasciitis.

There are 26 bones in each foot, and more than 100 muscles, tendons and ligaments, all of which, when injured or squashed into ill-fitting shoes, contribute to increased pressure on the plantar fascia, which in turn increases the likelihood if irritation and inflammation.

How to treat plantar fasciitis naturally 

First identify any causative factors, which include the following:

• Poor lower limb and lumbopelvic mechanics such as flat feet, knock knees and weak glutes
• Being overweight (increases the load/strain on the plantar fascia)
• Poor footwear (unsupportive or lacking shock absorption), especially if working on feet all day
• Tightness in the lower limb muscles, especially the calf and plantar fascia itself
• Stiffness in the ankle joint and surrounding foot joints, especially the big toe

Effective treatment of plantar fasciitis should take all these factors in to account, but primarily, non-surgical treatment of the plantar fascia should include stretching of the calves, hamstrings and plantar fascia, cooling their area with ice during acute pain, working on balance (try brushing your teeth while standing on one leg!) as well as massage of the plantar fascia with a massage ball/tennis ball/ golf ball.

How to reduce the pain of plantar fasciitis 

The most common treatment for plantar fasciitis is to Rest, Ice, Compress and Elevate, also known as the RICE method.

The method suggests keeping weight off your feet to reduce inflammation, icing the area three to four times a day for no more than 20 minutes, compression bands to eliminate pressure and stop the feet from becoming inflamed and irritated, and elevating the foot above chest level as much as possible.

Other treatment options include:

• Manual therapy such as osteopathy, providing soft tissue massage to the lower limb, mobilising joint restrictions in the lower limb and stretching to improve glutes and core strength, flexibility in the ankle and arch integrity. A physiotherapist or podiatrist may also strap the arch of the foot to assist in arch support in the short term, and to determine whether orthotics may be needed.
• Certain medications such as nonsteroidal anti-inflammatory drugs may assist in reducing inflammation and provide a degree of symptomatic relief. (Long-term use is not recommended, as it only treats the symptoms and not the cause.)
• Assessment from a podiatrist may reveal an underlying mechanical issue that may require a supportive orthotic device, or they may provide advice on appropriate footwear.

How to prevent getting plantar fasciitis

While treatments can help reduce the pain of plantar fasciitis, prevention is always the best method. Some simple lifestyle changes may be the best way to prevent plantar fasciitis from becoming a problem.

Preventative measures include weight loss, which lessens the pressure on the feet and choosing shoes that offer support and stability. Steer clear of high heels, make sure you replace your walking shoes regularly and avoid walking barefoot on hard surfaces as that can make plantar fasciitis worse.

Frequently Asked Questions

Q: Should I stay off my feet with plantar fasciitis?
A: Yes! It’s important to keep weight off your foot until the inflammation goes down, try keeping it elevated and icing it often.

Q: How long should I rest my foot with plantar fasciitis?
A: You should aim to rest your foot as much as possible for three to five days. After this period you can slowly start increasing your exercise, but if the pain worsens go back to resting until you’re able to increase exercise without pain.

Q: How bad can plantar fasciitis get?
A: Untreated plantar fasciitis can lead to hip, back and knee pain. Feet work alongside the tendons, ligaments, and muscles throughout the body, so when one is compromised, the others compensate which can lead to issues down the line.

Q: How is plantar fasciitis diagnosed?
A: Your doctor will check your feet and watch you stand and walk, they may also take an X-ray of your foot if they suspect a problem with the bones of your foot.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.