Plantar fasciitis (pronounced PLAN-tur fas-e-I-tis) is the most common cause of
persistent heel pain (pain on the underside of the foot). The condition is one that usually gets
better on its own but it can be persistent (not to mention extremely painful and debilitating)
and take between 6 and 12 months to resolve. There are a few things that you can do to help
yourself (as well as see a physiotherapist at Western House in Barnsley) during that time.
Read on to learn more…
ABOUT PLANTAR FASCIITIS
The plantar fascia is a thick, web-like ligament that connects your heel to the front of your
foot. Its role is to support the arch of your foot when walking and to act as a shock absorber.
As you can imagine the plantar fascia experiences a lot of wear and tear during your daily life
and too much pressure on your feet can damage or tear the ligaments. We used to think that
the plantar fascia became inflamed and the inflammation caused heel pain and stiffness.
However recent studies have suggested that the condition may involve degeneration (or wear
and tear to the tissue) rather than inflammation. The word “fasciitis” means “inflammation of
the fascia” so a more accurate name may be plantar fasciosis or plantar fasciopathy.
There can be many other causes of heel pain such as nerve, bone and tendon problems in the
foot and associated conditions such as rheumatoid arthritis. If there hasn’t been a specific
diagnosis for your pain your physiotherapist may call it “plantar heel pain”. The plantar area
refers to the underside of your foot which is where the pain from planter fasciopathy arises.
WHAT CAUSES PLANTAR FASCIITIS?
There are numerous factors which can contribute to someone’s risk of developing plantar
fasciitis. These include:
- Being overweight or obese. This increases the pressure on your plantar fascia (especially if you suddenly gain weight).
- Active men and women between the ages of 40 and 70 are at the highest risk for developing
- Having high arches in your feet or being flat-footed and other structural foot problems may
result in the development of plantar fasciitis.
- Long-distance runners or high impact activities such as jumping and dancing put stress
more the plantar fascia making it more likely to develop plantar fasciitis. Around one in 10
people who regularly run experience the condition.
- Spending a lot of time on your feet, for example, if you have a very active job such as
working in a factory.
- Women who are pregnant can experience bouts of plantar fasciitis, particularly in late
pregnancy due to the temporary weight pain. Hormones associated with your pregnancy can
also cause your ligaments to relax.
- Wearing poor footwear with a lack of arch support and soft soles can also contribute to
plantar fasciitis. Here at Western House our physiotherapists and chiropodist (podiatrist)
often see an increase during the summer months due to people wearing flat unsupportive flip
WHAT ARE THE SYMPTOMS OF PLANTAR FASCIITIS?
The main symptom of plantar fasciitis is pain at the bottom of your heel, or sometimes in the
arch of your foot. It usually affects just one foot, but it can in one in every three people, affect
both feet. The pain may develop gradually over time and can be dull or sharp. Some people
report during their physiotherapy assessment a burning or ache on the bottom of their foot
extending from their heel which can cause them to limp or be reluctant to put their heel down
when walking. The pain is often worse on a morning when you take your first few steps
getting out of bed. It has often been described as “Like walking on glass”. Similar symptoms
can be experienced after you have been inactive for a while and get up from a sitting position
or lying down.
Pain may also flare up after you have been doing a prolonged activity such as walking or
running – sometimes after you have finished the activity rather than during it. Some people
report during physiotherapy that their symptoms are worse initially on walking but can then
You may also find that your pain is made better or worse depending on the type of footwear
you have on. Typically, worse in a flat unsupportive shoe (like wellies) and better in good
footwear like a pair of supportive and cushioned trainers.
HOW PHYSIO’S DIAGNOSE PLANTAR FASCIITIS
Your physiotherapist or chiropodist (podiatrist) will usually be able to diagnose plantar
fasciitis by asking you questions about your symptoms and examining your foot. They will
also ask you about your general health and the sort of activities that make your pain better or
worse. The physio or chiropodist (podiatrist) examining you will check your foot positioning
as well as the movements of your foot and ankle and feel for tenderness by pressing in certain
areas. This is to make sure that the pain isn’t a result of a different foot problem. The
physiotherapist will also ask you to perform some simple tasks such as balancing on each leg
and observe your walking.
Sometimes, your physiotherapist may recommend you have an X-ray or ultrasound to rule
out other causes, such as a bone problem. You don’t always need further tests or scans to
diagnose plantar fasciitis though. At Western House Consulting Rooms we are able to
provide details on local physiotherapists providing an ultrasound scanning service so please
ask us for further information.
HOW CAN MY BARNSLEY PHYSIO HELP ME TREAT MY PLANTAR FASCIITIS?
The majority of people with plantar fasciitis find that they make a complete recovery within
about six months with following the correct advice. You need to stick with the
recommendations and follow any exercises you have been given by your physiotherapist or
chriropodist (podiatrist) for 6-8 weeks though before you may notice any improvements in
- Make sure you are wearing good supportive shoes – supportive and well cushioned trainers
with laces are one of the best options, but your physiotherapist can give you further advice
about footwear. Flip flops and bare feet are not recommended!
- Modify your activities so that you can allow your foot to rest by taking regular breaks from
walking for example and reduce the length of time you are on your feet whenever possible.
- You may need to take time off from certain high impact exercises (such as running) if these
activities are causing pain. Sometimes running on a softer surface can help and when you
return to running make sure you start slowly. It can be a good idea to switch to low impact
activities to allow the plantar fascia time to heal such as swimming or cycling.
- Your physio will provide you with an individual programme of initial stretches for the
plantar fascia, calves and surrounding muscles. These will gradually be progressed to
“loading” exercises for the plantar fascia which in recent studies has been shown to be an
effective treatment for plantar fasciitis.
- Apply an ice pack or a frozen bottle of water (wrapped in a towel) to your heel area for 15-
20 minutes a couple of times a day.
- Your physiotherapist may recommend the use of gel heel pads or orthotics to help alleviate
some of the pain by distributing pressure.
- Do your best to stay at a healthy weight or if you are offer advice try to lose weight to
reduce the pressure on your plantar fascia. Your physio can give you some advice on the
safest ways to exercise in order to help you with this.
- Try not to be barefoot at home – even first thing on a morning and keep some supportive
footwear to use inside the house.
- Taping and strapping may be recommended by your physio to take some of the load off the
- Speak to a pharmacist for advice regarding over the counter pain-relieving medication.
OTHER TREATMENTS FOR PLANTAR FASCIITIS
You will need to continue with your stretches and advice for a few months to see an
improvement in your symptoms. If, however, after this timescale your symptoms are not
changing or your pain is severe and affecting your day to day function your physiotherapist at
Western House in Barnsley may speak to you about other treatment options. These may
A steroid injection may give you some short-term relief, particularly if your pain is severe.
There are pros and cons with injections so it’s important to discuss it with your
physiotherapist or NHS GP. Here at Western House in Barnsley, we are able to recommend
local practitioners offering steroid injections under ultrasound guidance which ensures a great
accuracy of needle placement. It is still important after a steroid injection to continue with the
stretches and advice.
If after 6-12 months of your symptoms failing to improve your physiotherapist may ask your
NHS GP to consider referring you to see a consultant. Surgery is an option for plantar
fasciitis but should always be considered as a last resort when all other conservative
treatments have failed.
PREVENTION OF PLANTAR FASCIITIS
Making a few lifestyle changes, as advised by your Barnsley physiotherapist at Western
House, can reduce your risk of developing plantar fasciitis (particularly if you are a runner):
- Make sure you wear good-quality trainers that have good cushioning or shock absorption.
- Get advice on the best shoes for you – plenty of running shops now offer this service.
- Replace your trainers as soon as they become worn out. Around 400 to 500 miles is the
limit for each pair of shoes before you should buy new ones.
- Avoid exercising on a hard surface and incorporate low impact exercises into your routine
such as cycling.
- Make sure you regularly stretch, both before and after exercise and build strength in your
- Maintain a healthy weight.
If you or any other person has a medical concern, you should consult with your NHS GP or
physiotherapist or seek other professional medical treatment. Never disregard professional
medical advice or delay in seeking it because of something that you have read on this blog or
in any linked materials.
To book an appointment to see our chiropodist (podiatrist) or one of our team of Barnsley
Physio’s at Western House Consulting Rooms, please contact us on (01226) 730249.