Plantar Fasciopathy

Plantar fasciopathy is a common work-relevant condition affecting the plantar fascia of the foot which is often seen within occupational health clinics. 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?

The majority of plantar fasciopathy cases can be treated conservatively with physiotherapy treatment and advice, however, your attitude and the actions you take are the most important factors in preventing long-term problems. The most effective way to manage symptoms of plantar fasciopathy are to

  1. 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.
  2. 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.
  3. Apply an ice pack (wrapped in a towel) to reduce pain and inflammation.
  4. Massage your plantar fascia by rolling your foot over a frozen bottle of water or a tennis/cricket ball.

How can physiotherapy help? 

At Physiotherapy Matters, our physiotherapists can conduct a thorough assessment to confirm the diagnosis and work with you to help you manage pain and return to normal activity by

  1. Helping youunderstand your condition
  2. Helping identify the factors that may be aggravating your symptoms
  3. Providing advice on how to minimise your aggravating factors
  4. Completing ergonomic workplace assessments to minimise any work-related risk
  5. Developing symptom management strategies so you always feel in control
  6. Providing an individualised exercise program based around 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
  7. Providing additional manual therapies that may help ease symptoms, such as
    1. Taping to provide support to the plantar fascia and offload it to alleviate symptoms whilst you build up your exercises
    2. Soft tissue massage to reduce any muscular tension in the surrounding muscles
    3. Acupuncture for reduction of pain and inflammation
  8. Referring for additional services if required including
    1. Podiatry/foot clinic to consider use of orthotics and review footwear
    2. Shockwave therapy (see our page on shockwave therapy for further information on this)
    3. Corticosteroid injection – to reduce pain and allow exercise management

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