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Plantar Fasciitis: What it is and how to treat it

While a great deal of us have heard of the condition known as Plantar Fasciitis, far fewer may know exactly what it is, how it affects us and how exactly it is treated. Despite its rather exotic name, it is quite a common condition, one which can cause a great deal of pain on the underside of the foot, typically under the heel but also along the arch of the foot causing tenderness to the touch. It is a condition that can be particularly bad after periods of non-weight bearing, for example getting up in the morning or after long periods seated. It can also cause pain after long periods on your feet, yet you might be fine while you are active. Typically the pain subsides at some stage, and the condition itself can also be temporary, lasting anywhere up to around a fortnight. For some, however, it can be a longer term problem requiring professional advice and medical intervention.

Causes

Plantar Fasciitis develops when the tissues running between the heel area up to the foot’s arch become inflamed. This area acts as the body’s natural shock absorber but can easily become damaged from repetitive daily wear and tear, sudden impacts or just something as simple as a barefoot walk across hard ground. There are links between the onset of Plantar Fasciitis and a sudden increase in activity levels, placing those who might have started jogging, joined the gym or taken up other physical activities at more risk. There are also strong links between the condition and obesity as well as those with flat feet.

Diagnosis

Generally, if the condition hasn’t improved within a fortnight, it may be a longer term issue and making an appointment with your local GP should be considered. Typically your doctor will explore the history of your condition and undertake a physical examination to rule out other potential causes of the pain. This may involve touching the heel to see if it causes pain and asking you to flex your toes upwards to tighten that area between heel and arch (the fascia) to examine it under tension.

Ultrasound might also be an option to help ascertain the fascia’s thickness. A thickness greater than 4mm is generally indicative of the condition and a diagnosis can be made.

Easing the pain

There are several things you can undertake yourself to help alleviate the pain caused by Plantar Fasciitis. The most common (and one of the most effective) is comfortable, supportive footwear with particular focus on the heel and the arch of your foot, making trainers and sports shoes ideal. The comfortable shoes should raise your heel a little bit and support your arch. Stretching your calf muscles three times a day for a few minutes is also very effective. Rolling your foot over a small soft ball such as a golf or tennis ball is also effective for stimulating and helping to stretch your foot. Some people also find pain relief from the application of ice packs or packs of frozen peas wrapped in a towel every few hours. For those still looking to keep fit and active, swimming or cycling is an ideal form of non-weight bearing exercise.

Important things to try and avoid are long periods on your feet, walking barefoot (particularly on hard surfaces) and any footwear that is backless such as flip-flops or sandals. Whether Plantar Fasciitis is a condition you’re able to successfully manage and treat at home or whether you need the advice and support of an orthopaedic foot and ankle specialist, effective treatment is nearly always a combination of understanding and managing the mechanics of your foot and treating the problem area. In persistent painful cases a steroid injection or extra-corporeal shockwave treatment might be needed to help combat inflammation. Extra-corporeal shockwave treatment is a well recognised, successful and safe treatment option which stimulates the soft tissue to heal within a short period of time. 

Sufferers generally make a full recovery but it is important to remember that often there is a specific reason why people develop Plantar Fasciitis in the first place. This is the key reason why seeking the help of a medical professional is a good idea, to help ascertain the root cause of the problem and prevent it from recurring further down the road.

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