Plantar fasciopathy is a common condition affecting the plantar fascia of the foot. The plantar fascia is a thick band of connective tissue which runs from the heel on the sole of the foot, along to the toes. It is important in supporting and maintaining the arch of the foot and creating stability through tension in the plantar fascia, as well as the transfer of force when walking/running.
Plantar fasciopathy tends to be worse on first steps in the morning or after a period of rest. The bottom of the heel may feel tender. It can also be worse when walking on harder surfaces, barefoot or going up stairs.
What causes plantar fasciopathy?
Heel pain can occur in people of all ages but tends to be more common in middle age, and affects females more than males. Pain usually presents if there has been an increase in volume or intensity of standing, walking or running, particularly in unsupportive footwear, causing the plantar fascia to become overloaded. Biomechanical and anatomical differences can affect heel pain, for example how your foot arch is shaped and your ankle range of movement. Some medical conditions can also be associated with heel pain, such as diabetes, while being overweight is also a risk factor due to the increased load through the plantar fascia.
How can I help myself?
Unfortunately, there is no quick fix for plantar fasciopathy, but you attitudes and the actions you take are the most important factors in speeding up recovery. The most effective way to manage symptoms of plantar fasciopathy are to
- Avoid prolonged standing, walking or running. Although it can often feel better when you are running, we know that this can aggravate symptoms and so rest is key.
- Talk to your GP or pharmacist about what pain relief or anti-inflammatory medication may be right for you. If your pain is controlled, you will be able to maintain more movement, while anti-inflammatory medication (eg ibuprofen) will reduce inflammation in the plantar fascia.
- Apply an ice pack (wrapped in a towel) to reduce pain and inflammation.
- Massage your plantar fascia by rolling your foot over a frozen bottle of water or a tennis/cricket ball.
When should I seek further help?
If you suspect you may have a frozen shoulder, contact your GP surgery for further assistance. They may refer you to a physiotherapist who can
- Assess your symptoms in order to confirm a diagnosis
- Help you understand your condition
- Develop symptom management strategies
- Provide an individualised exercise program based on progressive loading of the plantar fascia, which will improve the strength of the plantar fascia and it’s ability to transfer force when walking/running
- Determine whether onward referral may be appropriate, for example for a corticosteroid injection, or to podiatry to consider the use of orthotics.
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