Many of us attempt to manage an injury with a bit of rest, ice, and over-the-counter meds, hoping the problem will resolve naturally. But, there comes a point where professional expertise makes all the difference between a swift recovery and months of unnecessary discomfort
Let’s explore the warning signs, symptoms, and circumstances that would indicate the need for expert evaluation from foot and ankle specialists.
What is plantar fasciitis?
Let’s first answer the biggest question we get as foot and ankle specialists ‘What is plantar fasciitis?’
Plantar fasciitis is a common condition that causes pain in the heel and bottom of the foot. It occurs when the plantar fascia, a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes, becomes inflamed.
What are the symptoms of plantar fasciitis?
The most common symptom is sharp, stabbing pain in the bottom of the foot near the heel. This pain is usually worse in the morning with the first few steps out of bed or after periods of inactivity. The pain can also increase after long periods of standing or after exercise.
What causes plantar fasciitis?
This condition is caused by strain and stress on the plantar fascia ligament. This can result from:
- Overuse, such as from excessive running or standing.
- High-impact activities.
- Poor footwear with inadequate support.
- Being overweight.
- Having high arches or flat feet.
- Tight Achilles tendons or calf muscles.
Who is at risk for developing plantar fasciitis?
Several factors can increase the risk of developing plantar fasciitis, including:
- Age: It is most common in individuals between 40 and 60 years old.
- Certain types of exercise: Activities that place a lot of stress on the heel and attached tissue, such as running, ballet, and dance aerobics.
- Foot mechanics: Having flat feet, a high arch, or an abnormal walking pattern can affect the way weight is distributed when you’re standing and put added stress on the plantar fascia.
- Obesity: Excess weight can put extra stress on the plantar fascia.
- Occupation: Jobs that keep you on your feet for long periods, such as factory workers, teachers, and waitstaff.
How is it diagnosed?
A doctor will diagnose plantar fasciitis based on your medical history and a physical examination. They will check for areas of tenderness in your foot and evaluate your foot arch and heel. Imaging tests like X-rays or MRIs are usually not necessary but may be used to rule out other problems. Ultrasound scans can be used to confirm the diagnosis.
What are the treatment options?
Treatment for plantar fasciitis typically includes:
- Rest: Reducing or avoiding activities that worsen the pain.
- Weight loss: even being a little bit too heavy makes recovery harder.
- Ice: Applying ice to the affected area to reduce inflammation and pain.
- Stretching: Exercises to stretch the plantar fascia and Achilles tendon.
- Orthotics: Custom or over-the-counter shoe inserts to support the arch and heel.
- Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, rarely reduce pain.
- Physical therapy: A physical therapist can design a specific exercise program to strengthen the lower leg muscles and stabilise the ankle and heel.
Are there any advanced treatments?
Yes, if standard treatments are not effective, advanced options include:
- Corticosteroid injections: These can help reduce inflammation and pain.
- Extracorporeal shock wave therapy (ESWT): Uses sound waves to stimulate healing in the plantar fascia.
- Regenerative Plasma Therapy: Injections of your own blood platelets aims to promote healing, but has little supportive evidence.
- Calf stretch Surgery: this can be effective if exercises alone don’t work.
- Heel Surgery: In rare cases, surgical intervention may be necessary to detach the plantar fascia from the heel bone.
How long does it take to recover from plantar fasciitis?
Recovery time can vary depending on the severity of the condition and the treatment approach. Many people begin to feel relief within a few months with conservative treatment. However, it can take 6 to 12 months for symptoms to completely resolve. The majority of sufferers recover with simple treatments over this period.
Persistent cases may take longer and a small percentage may require advanced treatments or surgery.
Can plantar fasciitis recur?
Yes, plantar fasciitis can recur if the underlying causes are not addressed. Preventive measures such as maintaining a healthy weight, wearing supportive shoes, and doing regular stretching exercises can help reduce the risk of recurrence.
Are there any home remedies for plantar fasciitis?
Several home remedies can help manage the symptoms of plantar fasciitis, including:
- Resting and avoiding activities that aggravate the pain.
- Applying ice to the affected area for 15-20 minutes several times a day.
- Weight loss if even only slightly heavy.
- Performing stretches for the plantar fascia and Achilles tendon.
- Using over-the-counter pain relievers.
- Wearing supportive shoes or using orthotic inserts.
How important is footwear?
Footwear plays a crucial role in managing and preventing plantar fasciitis. Shoes with good arch support, cushioning, and a slightly raised heel can help reduce stress on the plantar fascia. Avoid wearing worn-out shoes, high heels, or shoes with little support.
What types of exercises are beneficial for helping this condition?
Stretching and strengthening exercises can be very beneficial for plantar fasciitis. Some effective exercises include:
- Calf stretches: Stand facing a wall with one foot in front of the other, keeping the back leg straight and heel on the ground, and lean forward.
- Slant board stretches: an effective solution and easy to perform.
- Plantar fascia stretches: Sit down, cross one foot over the opposite knee, and pull the toes back toward the shin.
Can weight loss help?
Yes, weight loss can help reduce the stress and strain on the plantar fascia, which can alleviate pain and prevent further damage. Even if you are only a little overweight losing this excess will help. Maintaining a healthy weight through a balanced diet and regular exercise can be beneficial for overall foot health.
Is it related to other conditions?
Plantar fasciitis can sometimes be associated with other conditions, such as flat feet, or high arches. Sufferers may have Achilles tendinits too. It is also more common in individuals with certain systemic conditions like diabetes, arthritis, and other inflammatory diseases.
What are heel spurs and how are they related?
Heel spurs are bony growths that develop on the bottom of the heel bone. However, heel spurs do not always cause pain and can be present without plantar fasciitis.
Can plantar fasciitis affect both feet?
Yes, it can affect both feet, although it is more common for one foot to be more severely affected than the other. When both feet are affected, it can significantly impact mobility and quality of life.
What role can physiotherapy play?
Physiotherapy can play a significant role in treating plantar fasciitis. A physiotherapist can develop a tailored exercise program to stretch and strengthen the plantar fascia, Achilles tendon, and lower leg muscles. They may also use techniques like massage, ultrasound therapy, and taping to reduce pain and inflammation.
Can it be prevented?
While it may not be possible to prevent plantar fasciitis entirely, several strategies can reduce the risk:
- Maintain a healthy weight to reduce stress on the feet.
- Choose footwear with good arch support, cushioning, and a proper fit.
- If increasing activity levels, do so gradually.
- Avoid high-impact activities on hard surfaces.
- Perform regular stretching exercises for the plantar fascia and Achilles tendon.
- Avoid walking barefoot on hard surfaces.
Is it common among athletes?
Yes, plantar fasciitis is common among athletes, particularly those involved in sports that put a lot of stress on the feet, such as running, basketball, and tennis. High-impact activities and repetitive motions can lead to overuse sport injuries like plantar fasciitis.
What should I do if my symptoms worsen?
If your symptoms worsen despite home treatment, it is important to consult a healthcare professional. They may recommend more intensive treatments, such as physical therapy, corticosteroid injections, or advanced therapies like ESWT (shockwave). Ignoring worsening symptoms can lead to chronic pain and further complications.
Can night splints help with plantar fasciitis?
Night splints can be helpful for some people. These devices hold the foot in a dorsiflexed position overnight, which helps stretch the plantar fascia and Achilles tendon, potentially reducing morning pain. The evidence for their use is, however, weak.
Are there any alternative therapies?
Some alternative therapies that may help with plantar fasciitis include:
- Acupuncture: Can help relieve pain and improve healing.
- Chiropractic care: Can address misalignments that may contribute to plantar fasciitis.
- Massage therapy: Can help reduce tension in the plantar fascia and surrounding muscles.
Is surgery a common treatment option?
Surgery is not a common treatment for plantar fasciitis and is typically considered only when other treatments have failed. Surgical options may include release of a tight calf muscle; or plantar fascia release, which involves cutting part of the plantar fascia to relieve tension and reduce inflammation.
What is the prognosis for someone with plantar fasciitis?
The prognosis for plantar fasciitis is generally extremely good, especially with early and appropriate treatment. Most people experience significant improvement within a few months. However, some individuals may have persistent symptoms and require ongoing management.
How can I find specialist help for plantar fasciitis?
At the London Foot and Ankle Centre we offer expert diagnosis and treatment for stubborn cases of plantar fasciitis. To make an appointment get in touch via our contact form or contact us at:
0207 078 3800
