Plantar Fasciitis

What is Plantar Fasciitis?

Plantar fasciitis is one of the most common causes of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of each foot and connects the heel bone to the toes, known as the plantar fascia.

Plantar fasciitis commonly causes stabbing pain that often occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting. [1]

Plantar Fasciitis

What causes Plantar Fasciitis?

It's not always clear why this happens.

You may be more likely to get plantar fasciitis if you:

  • are 40 to 60 years of age
  • recently started exercising on hard surfaces
  • exercise with a tight calf or heel
  • overstretch the sole of your foot during exercise
  • recently started doing a lot more walking, running or standing up
  • wear shoes with poor cushioning or support
  • are very overweight [2]

What can you do about Plantar Fasciitis?

You should aim to do the following exercises/stretches for around 4-6 weeks to notice benefit, alongside modifying activity levels and repetitive strain of the area and wearing appropriate footwear.

Plantar Fasciitis Exercises

Sitting Plantar Fascia Stretch

Sit down and cross one foot over your knee. Grab the base of your toes and pull them back towards your body until you feel a comfortable stretch. Hold for 15 to 20 seconds and repeat 3 times. [3]

Plantar Fasciitis Exercises

Plantar Fascia Stretch

Sit down and rest the arch of your foot on a round object, such as a tin of beans. Roll the arch in all directions for a few minutes. Repeat this exercise at least twice a day. [3]

Plantar Fasciitis Exercises

Achilles Tendon and Plantar Fascia Stretch

Loop a towel around the ball of your foot and pull your toes towards your body, keeping your knee straight. Hold for 30 seconds. Repeat 3 times on each foot. [3]

Plantar Fasciitis Exercises

Wall Push

a) Facing a wall, put both hands on the wall at shoulder height and place one foot in front of the other. The front foot should be approximately 30 cm (12 inches) from the wall. With the front knee bent and the back knee straight, bend the front knee towards the wall until the calf in your back leg feels tight. Relax and repeat 10 times.

b) Repeat a) but bring the back foot forward a little, so that the back knee is slightly bent. Repeat this 10 times. [3]

This guide can help you to understand if you’re exercising at the right level. It’ll also let you see how much pain or discomfort is acceptable.

It can be helpful to rate your pain out of 10 (0 being no pain 10 being the worst pain you have ever had), for example:

  • 0 to 3 – minimal pain
  • 4 to 5 – acceptable pain
  • 6 to 10 – excessive pain

Pain during exercise
Aim to keep your pain within a rating of 0 to 5. If your pain gets above this level, you can change the exercises by:

  • reducing the number of times you do a movement
  • reducing the speed of a movement
  • increasing rest time between movements

Pain after exercise
Exercise should not make your existing pain worse overall. However, practicing new exercises can sometimes cause short term muscle pain as the body gets used to moving in new ways. This kind of pain should ease quickly and your pain should be no worse the morning after you’ve exercised. [4]

If in the meantime you develop worsening or changing pain or symptoms, weakness of the foot or leg, or any altered sensation to the area please seek a medical review, or contact 111/Urgent Care/A+E out of hours if needed

References:

1 - https://www.hopkinsmedicine.org/health/conditions-and-diseases/plantar-fasciitis#:~:text=Plantar%20fasciitis%20is%20one%20of,the%20base%20of%20the%20toes. Hopkins Medicine – Plantar Fasciitis

2 - https://www.nhs.uk/conditions/plantar-fasciitis/ NHS UK Plantar Fasciitis

3 - https://www.versusarthritis.org/media/21790/plantar-exercise-sheet.pdf Versusarthritis Plantar Fasciitis

4 - NHS Inform Scot - https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/exercises/exercises-for-tennis-elbow/