How to treat plantar fasciitis

How to treat plantar fasciitis

With three months to go until the London Marathon on Sunday 3 October 2021, your training should be well underway. Hopefully you’ve managed to avoid injury but, as many runners will know, plantar fasciitis can put an abrupt end to your dreams of finishing.

In this article our Sports Medicine Podiatrist - Mr Liam Stapleton - will help you recognise the onset of plantar fasciitis, identify possible causes, debunk a few myths and talk about how to access treatment for plantar fasciitis at Benenden Hospital.

What is plantar fasciitis?

Plantar fasciitis is a common complaint, with one in ten people in the UK suffering from the condition at some point in their lifetime.

Some people will remember exactly when and where the pain started, even many years later, and this could be a sign of a plantar fascia tear, which may need treating differently.

True plantar fasciitis will appear gradually. Almost always it begins with pain in the heel of one foot when you first stand after getting out of bed. Generally, it eases off with activity and returns with rest. As things worsen, you’ll spend more and more time in pain and may start walking with a limp.

Feelings of numbness, pins and needles or electric shocks could be a sign of a pinched nerve and should be assessed professionally.

Why do I have plantar fasciitis?

This question is often overcomplicated by sufferers on online forums when it’s quite simple: plantar fasciitis can be caused by doing too much too soon after too long doing too little!

So, what does this mean? In a nutshell - too much exertion, too quickly. Either you’re a fitness enthusiast who has suddenly increased the amount or type of exercise you do without taking the time to acclimatise. Or perhaps you have a more sedentary lifestyle or have put on weight over Christmas and want to get fit in time for summer.

Every part of our body needs to adapt and grow stronger as we increase our activity. If your plantar fascia starts complaining, it was just the weakest link in the chain. Just as if your kneecap tendon or your Achilles were the weakest link, they would complain first!

But there are some other factors to consider. If you already have a weakness, these may be the final straw:

  • Old worn-out trainers: running shoes have a life span of only 100-500miles, you need new ones regularly
  • Unsupportive shoes: ballet pumps or flip flops aren’t designed for walking any great distance. Pick the most appropriate shoes for your chosen activity
  • No pain no gain? Don’t run until it hurts, make gradual increases in training load, be deliberate and calculating about it. It’s recommended that you only increase your training by 10% per week
  • Tight calves: evidence suggests that when calves are tight enough to restrict ankle movement this increases plantar fascia tension
  • Poor big toe movement: this can be either functional or structural, but it will lead to compensation during gait
  • People believe a flatter foot will cause plantar fasciitis, but nearly as many people with high-arched feet suffer too

What’s the treatment for plantar fasciitis?

There are many treatments and self-help regimes everywhere for plantar fasciitis. These generally fit into one of two categories:

  • Symptom relief
  • Repair and recovery

Pain killers and anti-inflammatories are the most obvious way to relieve symptoms. And most stretches, all forms of massage (no matter how vigorous), icing, rolling on frozen bottles or spiky balls, taping and arch supports or most orthotics only offer short-term symptom relief.

Repair and recovery are best achieved by identifying what caused the plantar fasciitis in the first place and reducing it (not necessarily stopping altogether). Then gradually day by day, you should perform strengthening exercises to increase your tolerance to activity for future.

Remember, good nutrition and good sleep all improve recovery. We also know smoking and too much alcohol decrease your body’s ability to repair. So, make improving your diet and lifestyle a priority.

Some people will still need some professional help. Injections used to be the preferred choice, but these now should only be done on specific cases and ultrasound-guided for accuracy. Platelet-rich plasma injections offer an alternative, encouraging tissue to self-repair and regenerate.

However, shockwave therapy (also known as Extracorporeal Shockwave Treatment or ESWT), which uses a special device to pass impulses of energy through the skin to your injury is now the go-to treatment, curing 75-80% of patients in only three applications.

How to access treatment for plantar fasciitis at Benenden Hospital

Our podiatry service offers a full range of diagnoses and treatments – including preventative care – for problems affecting your feet.

Our experts will create a specific treatment plan just for you and – with speedy diagnosis and treatment in one place – you can get back to training as quickly as possible.

To find out more, complete our online enquiry form or call our Private Patient team on 01580 363158.

Published on 03 August 2021