Plantar fasciitis

The plantar fascia is a thick band of connective tissue that supports the arch of your foot. It attaches from the heel to the toes.

What is plantar fasciitis?

The plantar fascia can become irritated and the tissues become swollen and irritated.

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Causes and symptoms

Causes of plantar fasciitis

The plantar fascia can become irritated with an increase in load such as walking longer distances or having a job with lots of standing.

The capacity of the plantar fascia to withstand load can reduce due to factors such as ageing, changes in hormone levels (menopause), diabetes particularly if poorly controlled and weight gain.

Symptoms of plantar fasciitis

Pain can be felt under the heel which can radiate into the arch of the foot.

Diagnosis of plantar fasciitis

Pain is aggravated when getting out of bed and taking the first few steps and the first few steps after sitting for a while. Pain will ease after the initial few steps.

Self management of plantar fasciitis

Initially, allow the pain to ease by reducing or changing the aggravating activity. Look at your health and lifestyle – losing weight through healthy eating can help to ease symptoms.

It can take 3-6 months for symptoms to improve. Where you have a job with a lot of standing or activities with lots of loading such as running it can take nine months or more.

Orthotics that fit in your shoes may provide pain relief. This can be a gel heel cup or an arch support which can be purchased at a chemist or on-line. It is important that it is comfortable to wear.

Rehab progressions?

As symptoms settle it is very important to start to gradually increase the load on the plantar fascia so that you can return to your activities. To maintain fitness you can go swimming, cycle or take exercise classes such as pilates, floor based exercises (bums and tums) or yoga.

Stretches of the calf and plantar fascia and calf strengthening exercises can help to load the plantar fascia.

Return to sport?

If you are returning to running or sports that involve higher loading of the plantar fascia you must start to increase activity gradually and look at the symptom response. Find a level comfortable for you and then gradually increase your activity. It is important however to keep on doing your exercises even when the pain has gone to prevent reoccurrence.

Exercises for plantar fasciitis

Exercise 1: toe curls with towel

Sit on a chair
Smooth the towel out and place one foot on it, flat
You are going to be moving the towel toward yourself, so have extra fabric in front of your toes
Keeping the heel still, pull the towel toward you by scooping it in with your arch and toes
Use both sides of your foot (all five toes) and try to create a deep dome under the arch area
You will only get a little bit of the towel to move each time you extend and pull back

Exercise 2: plantar fascia stretch

In a sitting position with your leg placed on the other leg
Put one hand on your heel
Use the other hand to pull your toes away from your heel
Feel the stretch
Hold for 30 seconds

Exercise 3: calf stretch

Stand with your injured leg back in a step standing position
Stretch your leg, keeping your knee straight
Feel the stretch in the back of your calf
Hold for 30 seconds

Exercise 4: plantar fascia massage

Sit in a chair
Place your foot on a rolling pin, strong bottle or other cylinder-shaped item
With a gentle pressure roll your foot forward and back to massage the sole of your foot

Exercise 5: plantar fascia dynamic stretch

In a standing position
Make sure you are supported
Rest your toes onto a rolled-up towel
Raise your heel
Lower your heel slowly down

Exercise 6: plantar fascia dynamic stretch on a step

In standing position
Make sure you are supported
Rest your toes onto a rolled-up towel on the edge of a step
Raise your heel
Lower your heel slowly down

Exercise 7: heel stretch

In standing on the edge of a step (single leg)
Make sure you are supported
Stretch your heel over the edge of the step
Feel the stretch
Hold for 30 seconds

What next?

If you are still experiencing symptoms despite following the above advice, it is important you seek advice from your GP. Your GP may decide to refer you to the musculoskeletal clinic or to a physiotherapist.

Page updated 01/12/2020. Review date 01/01/2024

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