This month we cover a common condition that causes foot pain. Plantar fasciitis causes pain on the bottom of the foot around the heel and the arch. The plantar fascia is the name given to the connective soft tissues (muscles, ligaments and tendons) that support the arch of the foot. These tissues can be under a large amount of pressure and may be damaged by strains or sprains. This is when the pain develops.
Typically, the pain in plantar fasciitis is worse first thing in the morning when you begin to walk, or if you have been resting and get up to move again. It can improve with exercise, but then get worse again after a period of rest. Trying to lift your toes from the floor with your foot flat on the ground can also be painful as it stretches the affected tissues.
It is not always clear why some people develop plantar fasciitis. Sometimes it can happen with no clear trigger. It is known that several factors can increase the risk of developing it.
Plantar fasciitis is more common in those who:
- are aged between 40 and 60 years old
- have recently started exercising on hard surfaces
- exercise with a tightness in their calf or heel
- overstretch the sole of the foot during exercise
- have recently started doing a lot more walking, running or standing up
- wear shoes with poor cushioning or support
- are very overweight.
Many cases of plantar fasciitis will get better over time using simple measures. The best way to manage the pain is with simple painkillers like paracetamol and ibuprofen (if you are able to take it). Applying ice to the area up to three times a day may help, along with regular simple stretching exercises (available at www.rdr.link/ <www.nhsinform.scot> if you search for ‘heel pain’). Resting the foot is recommended.
Footwear is also really important to help manage plantar fasciitis. Shoes with arch support and cushioning at the heel will be most comfortable. High heels, slip on shoes, flip flops and walking barefoot are not recommended as they can make symptoms worse. Sometimes insoles can be used to raise the heel slightly- this may help take some pressure off the heel. Lastly, weight loss if you are overweight can also help improve the symptoms.
Some cases of plantar fasciitis will not improve with the steps outlined above. In these cases specialist input from a physiotherapist, a podiatrist or an orthopaedic specialist may be required. The input from these specialties might be further exercises, custom fit insoles, steroid injections or even surgery in some cases. In some areas you may be able to self- refer to your local the physiotherapy service, you might need a referral from your GP or you might choose to see a private physiotherapist of your choosing.
Plantar fasciitis may take up to a year to settle down. Unfortunately, there is no quick fix as the tissues take time to heal. This can be very frustrating for people who are suffering with the condition. To prevent it starting, wearing appropriate footwear in the first instance can really help. Replacing sports footwear when it is worn out is essential, for example running shoes last for around 500 miles before being worn out. Building up distance with exercise slowly is also recommended and stretching appropriately during warm down sessions. Your feet will certainly thank you in the long term for wearing good, supportive shoes!
For further information on plantar fasciitis from the NHS visit https://www.nhs.uk/conditions/plantar-fasciitis/
