The name "plantar fasciitis" actually means that there is inflammation under the foot, but research has nevertheless shown that it is a degenerative process (wear-and-tear changes) of the fascia and not inflammation. Over time the fascia breaks down and its shock-absorbing effect becomes smaller. Anyone can get pain under the heel, but it is often runners at all levels who receive the diagnosis. Plantar fasciitis can affect people of all ages, but is most common after the age of 40.
Do I have plantar fasciitis?
Plantar fasciitis causes a stabbing pain under the heel and can radiate along the underside of the foot towards the toes. The pain is usually worse in the morning or after sitting still for a longer period, when the first steps can be painful. The pain then improves somewhat as the day goes on and you are moving lightly. If you have plantar fasciitis, you will get an increase in pain when you take part in weight-bearing activities that put load on the heel, such as prolonged standing, walking and running.
How is the diagnosis made?
If you experience symptoms of plantar fasciitis, you should see a practitioner or doctor to get the right diagnosis. The diagnosis is usually made based on symptoms and a clinical examination. Diagnostic ultrasound is a simple and accessible imaging examination that can assess the appearance of the plantar fascia and confirm the diagnosis. The plantar fascia is then thickened and has a somewhat altered connective tissue structure. In addition, it is possible to see whether there is a rupture in the fascia. In some cases, further imaging examinations may be needed to rule out other conditions.
Why do I get plantar fasciitis and what risk factors are there?
Plantar fasciitis usually occurs after overload of the attachment of the plantar fascia to the heel bone. This happens first and foremost with prolonged standing, walking or running.
Risk factors for developing plantar fasciitis are:
- being overweight
- high arches or flat feet
- reduced mobility in the ankle
- altered gait pattern and running technique due to increased supination or pronation
- tight calf, hamstring and gluteal muscles
- muscle imbalance around the hip
- prolonged standing or walking
- too rapid an increase in training or activity, in both frequency and intensity
- (in some rheumatic diseases such as Reiter's disease or ankylosing spondylitis, the disease can begin with plantar fasciitis in both feet)
How is plantar fasciitis treated?
Treatment of plantar fasciitis consists of both reducing pain and increasing tolerance to load. For a period it is sometimes necessary to avoid the activity that aggravates the symptoms, such as running. In the early phase, stretching the foot and calf muscles can help, and taping can provide offloading and pain relief.
The most important treatment is strengthening exercises for the foot and calf muscles, as well as individually tailored exercises. Exercises for motor control are also important.
Shockwave treatment has been shown to have a good effect on plantar fasciitis together with exercises. For a few people, a cortisone injection may be considered if exercises and other treatment do not have an effect. Surgery may also be considered if no other measures have an effect.
Starting treatment early usually shortens the course of treatment, and it is possible to return to your previous activity level. It is not wise to ignore symptoms, as a late start to treatment often leads to a longer course of treatment.
Our practitioners have good experience with plantar fasciitis. Get in touch for an examination and treatment plan.
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