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Plantar fasciitis

Presenting as pain in the bottom of the heel or along the length of the arch, plantar fasciitis is generally an exceedingly common complaint where I've worked. Pain is more commonly present when first getting out of bed in the morning or when getting up from a period of being sedentary.

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A person standing on one foot and gripping their painful heel.

About Plantar Fasciitis

The plantar fascia attaches to the bottom/front of the heel bone and stretches to the metatarsal heads on the feet. 

Pain can therefore only really be under the heel or arch; if it is anywhere else, then other structures may be affected. 

The plantar fascia has several functions for the foot, and so when it is painful, it can really easily limit how much you can do. Fortunately, there are plenty of ways to ease the symptoms of plantar fasciitis.
 

Types of Plantar Fasciitis

Plantar fasciitis should be treated differently according to the sub-type
1) Insertional 
2) Mid-portion
3) Rupture 
4) Inflammatory

A podiatrist holding a foot and palpating a painful heel.
A lateral (side) X-ray view of a foot with spurs on the heel at the plantar fascia and Achilles attachments.

What else could it be?

There are over 40 common conditions that have the 'heel pain' symptom. Common ones are:

How is plantar fasciitis diagnosed?

Clinical examination and a thorough history is often adequate, however, in some instances it can be useful to use imaging to

  • Confirm the diagnosis

  • Identify how severe the problem is

  • Rule out other problems.

Imaging that can be used for Plantar fascia issues is:

X-rays rarely provide useful information for people with heel pain as approximately a third of the population have a heel spur, and this is rarely ever a cause of heel pain. 

A man doing an ultrasound scan of the back of someone's heel.
A person standing on their tiptoes.

How is Plantar Fasciitis treated?

Plantar fasciitis is generally treated as a tendinopathy, and the general treatment for tendinopathies is 'loading', so doing exercises. However, the types of exercises and positions used will vary according to the type of tendinitis. 

Other treatments for Achilles Tendinopathy include:

How long does it take to cure plantar fasciitis?

The duration will vary based on:

  • Severity of the problem

  • Duration of the problem

  • How well patients stick to their treatment plan.

In my experience, most patients are able to return to nearly-normal activities within about 6-8 weeks although, the symptoms should have settled by 30-50% within the first 2 weeks. If the symptoms have not shifted, then reconsidering the diagnosis is the appropriate next step. 

No two people can be treated the same way when it comes to any medical issues, and the goal of how we treat patients is always to get you back to what you want to be doing. 

Lady running with her dog
Ready to say goodbye to your pain?

At Keep On Your Feet, we openly acknowledge that we cannot guarantee a cure for things: but we will work as hard as we can with you to help you reach your goals. 

If your symptoms fit the above, you will need to book a 'Foot Pain' consultation. This will be £95 and lasts approximately 60 minutes usually. If you need insoles, we'll give you some basic ones to try out (or some fancier ones and reduce their price!). 

This is a picture of Jeremy Ousey, director and podiatrist of Keep On Your Feet.

About the Author

Jeremy Ousey is the owner at Swansea's podiatry clinic: Keep On Your Feet. All the information found on this page was written by him (there's no AI or Chat-GPT here!), and has been carefully chosen to provide you with the information that you need to know about the condition. Jeremy has a Bachelor of Science in Podiatry, with honours, a Post-Graduate Certificate in Podiatric Sports Medicine, a Post-Graduate Diploma in Medical Ultrasound, and two Master's of Science degrees in the Theory of Podiatric Surgery, and Sports & Exercise Medicine. If you would like to know more about Jeremy, please click here.

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