Plantar Fasciitis

A painful condition relating to foot pain around the heel or sole of your foot. In this article we look at symptoms, causes and treatment options.

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What is Plantar Fasciitis?

Plantar Fasciitis is one of the most common causes of foot pain. Pain is generally experienced on the underside of the foot around the heel. The pain in the foot comes from inflammation of the plantar fascia, which is a band of tissue that runs under the foot. The Plantar fascia runs from the heel and then fans out to attach to the underside of the toes. The band of tissue is there to support the arch of the foot and absorb stress when walking.

What are Plantar Fasciitis symptoms?

Symptoms of Plantar Fasciitis include:

Sharp or stabbing pain in the foot
Pain first thing in the morning when getting out of bed
Pain gets better after the first few steps in the morning
The pain can return after running or walking for long periods of time
The pain can also be made worse by standing for a long time
Getting up after sitting for a long time can also bring about the pain
Sometimes the pain is aggravated by different types of footwear

Causes of Plantar Fasciitis

When on your feet and you are actively working the plantar fascia, you can cause small tears to occur in the tissue. Repeated stress through the plantar fascia can lead to irritation or inflammation in the tissues. Despite this, there are many other factors that can be adding to the problem.

Some additional factors for causing plantar fasciitis:

The surface(s) that you stand, walk or run on
The type or style of shoes you wear
Exercise levels
Carrying extra weight
In some cases inflammatory conditions such as rheumatoid arthritis

Diagnosing plantar fasciitis

There are many ways to diagnose plantar fasciitis, the main important part of diagnosing the problem is identifying the key areas of the problem that differentiate it from other foot pain conditions such:

Arthritis of the foot
Nerve compression around the foot
Referral pain from other areas of the body such as the spine
Stress fracture of the bones in the foot
Loss of fatty tissue under the heel
Bony growth at the base of the heel

Plantar fasciitis is mainly diagnosed from the history of your complaint as well as a physical examination by the chiropractor, physiotherapist or sports therapist.

At Skelian we also offer diagnostic ultrasounds to confirm the diagnosis by scanning the foot. These scans are performed by our experienced specialist physiotherapist. These scans will be able to show you a live image of your foot and where the problem is coming from or not.

Once you have been given a diagnosis of plantar fasciitis we have a variety of treatment options available at Skelian.

Treatment of plantar fasciitis

In most cases the longer a condition has been around the harder it is to treat. If you have been struggling with foot pain for longer than 2 weeks it is probably worth seeking help from one of our experienced chiropractors, physio or sports therapist. Alongside the length of time you have been suffering from foot pain, your work, life or exercise demands might also be contributing to the problem. The length of time you have had the foot pain and your lifestyle will determine the length of time you will need to be treated. Typically the longer you’ve had the pain the longer the course of treatment may last.

Types of treatment for plantar fasciitis

Soft tissue release and stretching

Generally speaking, stretching is one of the “go to” forms of treatment or home exercise for plantar fasciitis. The stretching exercises should be focused on the plantar fascia and Achilles tendon. Your chiropractor,physio or sports therapist will talk you through the home exercises needed to help progress your case. Alongside the stretching exercises, you will also be assessed for foot strength. If needed, you will be prescribed foot and ankle exercises to practice at home to help improve the function of the foot.

Shockwave therapy

Shockwave therapy is a fantastic and effective treatment for many cases of plantar fasciitis. The aim of shockwave therapy is to create micro trauma to the plantar fascia, which then stimulates a healing response by the body. Helping promote the healing of the plantar fascia tissues. At Skelian most of our practitioners are experienced at using the shockwave machine when treating plantar fasciitis.

Steroid injections

Steroid injections are in most cases a last resort when it comes to treating plantar fasciitis. If your symptoms are stubborn after trying several forms of treatment, then a steroid injection might be considered for your case. The aim of a steroid injection is to significantly reduce the inflammation in the problem area of the plantar fascia. These injections can only be performed a limited amount of times before the plantar fascia starts to experience a negative effect from the steroid injection.

Our steroid injections at Skelian are performed under ultrasound for ultimate accuracy by our specialist physiotherapist.

Modification of activities or lifestyle

When trying to recover from plantar fasciitis, you may need to change what you are doing on a regular basis, especially if it is contributing to your problem.

These changes include:

Use a padded or well cushioned shoe or footwear
Reduce the distance you are running or walking
Change to exercises that do not put pressure on the foot or heel such as swimming or cycling
Using tape to support the foot, ankle and surrounding muscles
Wearing a medical boot at night to continue stretching the plantar fascia at night
Reduce time spent on hard surfaces

Orthotics

Orthotics or supportive insoles put into your shoes or footwear might also help support the foot or help take pressure off of sensitive areas.

Icing

Some patients find putting ice around the area of pain helpful for reducing symptoms or speeding up the recovery of plantar fasciitis. If the ice treatment is too cold, patients have tried putting their feet in a container of cold water. The aim of this is to encourage the reduction of inflammation in the foot/feet.

Frequently Asked Questions

How is plantar fasciitis diagnosed?
Plantar fasciitis is typically diagnosed by a physio, chiropractor or another healthcare provider, who will perform a physical examination and take a medical history to assess the symptoms and severity of the condition.
During the physical exam, the healthcare provider may check for tenderness in the heel and arch of the foot and may ask the patient to perform some movements to evaluate the range of motion, flexibility, and strength of the foot and ankle. They may also observe the patient’s gait or the way they walk.
In some cases, imaging tests such as X-rays, ultrasounds, or MRI may be ordered to rule out other conditions, such as a stress fracture or tendonitis.
The practitioner may also ask about the patient’s daily activities, occupation, and footwear to determine potential factors that may contribute to the development of plantar fasciitis.
Overall, the diagnosis of plantar fasciitis is based on a combination of the patient’s symptoms, physical examination, and imaging studies if necessary.
What causes Plantar Fasciitis?
1. Overuse or excessive physical activity: Plantar fasciitis can develop when the plantar fascia is subjected to repetitive stress or strain, which can lead to small tears in the tissue.
2. Foot mechanics: Abnormal foot mechanics, such as flat feet, high arches, or pronation (inward rolling of the foot), can place extra stress on the plantar fascia and lead to inflammation.
3. Obesity: Being overweight or obese can put extra stress on the plantar fascia and increase the risk of developing plantar fasciitis.
4. Age: Plantar fasciitis is more common in middle-aged and older adults.
5. Footwear: Wearing shoes that do not provide adequate support or cushioning can increase the risk of developing plantar fasciitis.
6. Genetics: Some people may be more genetically predisposed to developing plantar fasciitis than others.
A study published in the Journal of Orthopaedic & Sports Physical Therapy in 2020 found that individuals with plantar fasciitis had altered plantar loading patterns compared to those without the condition. The study also found that incorporating exercises that specifically target the plantar fascia, such as heel raises and toe curls, can be effective in reducing pain and improving function in individuals with plantar fasciitis.
Another study published in the Journal of Foot and Ankle Research in 2021 suggested that using a foot orthotic, specifically a custom-made foot orthotic, may be an effective treatment option for individuals with plantar fasciitis. The study found that custom-made foot orthotics reduced pain and improved function in individuals with plantar fasciitis compared to a control group.
In summary, plantar fasciitis can have multiple causes, including overuse or excessive physical activity, foot mechanics, obesity, age, footwear, and genetics. Current research suggests that incorporating exercises that target the plantar fascia and using custom-made foot orthotics may be effective treatment options for plantar fasciitis.
How long does it take to recover from plantar fasciitis?
The recovery time for plantar fasciitis can vary depending on the severity of the condition and the type of treatment used. In general, it can take anywhere from a few weeks to several months to recover from plantar fasciitis.
Conservative treatments such as stretching exercises, physical therapy, rest, and the use of orthotic devices or arch supports may take several weeks to provide significant relief. It is important to continue these treatments for at least a few months to allow the tissue to heal and to prevent a recurrence of the condition.
In more severe cases, corticosteroid injections or surgery may be necessary. Recovery time for these treatments can also vary, but it may take several months before the patient is fully healed and able to resume normal activities.
It is important to note that recovery time can also depend on the individual’s age, overall health, and level of physical activity. It is best to consult with a healthcare provider for an accurate diagnosis and treatment plan.
What should I avoid doing if I have plantar fasciitis?
Ideally you need to reduce or avoid the following to help with your recovery from Plantar Fasciitis:
- Standing/sitting for a long time
- Wearing the wrong sort of shoes for your feet
- Pushing through the pain when walking for long distances
- Not performing home exercises
- Not reducing your weight if you are overweight.

Our team

Dani Cowley

Sports Therapist

“My goal is to help all my patients return to their preferred activity whilst maintaining a pain-free and healthy lifestyle. I always aim to go one step further by minimising the risk of future injury through rehabilitation plans and hands-on therapy.”

Bradley Mason

Physiotherapist

BSc Physiotherapy, MCSP, MHCPC, PH138341, OMT Spinal and Peripheral Manipulations

“I’m passionate about empowering individuals to achieve their full potential through caring tailored treatment and rehabilitation.”

Victoria West

Chiropractor

MChiro DC LRCC

“ Every patient’s health requirements are unique to them; my aim is to provide patients with care that is centred around their needs.”

Jonathan Wride

Specialist Physiotherapist

HCPC MCSP AACP PgC Injection Therapy, MSK Sonographer and Independent Prescriber:

“I’m passionate about giving patients instant access to high-level diagnostics and specialist treatments, helping to reduce the waiting times of patients and hopefully speeding up their recovery.”

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Chiropractic Follow up treatment – £48
Physiotherapy consultation – £75
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Follow up Sports therapy appointment – £35
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I cannot recommend Skelian enough. I have suffered through work and exercise related pain/discomfort for such a long time now but within 6 weeks Alex has identified the issues, got to work immediately and I have felt huge improvement. I have exercises to do at home also to ensure this is a long term gain. It’s really been a game changer. The team are professional, friendly and so focused on your needs. The whole experience has been top notch.

"Brilliant Service"

“Brilliant service. I got booked in very quickly when I was in quite some pain, which was very much appreciated. Alex has talked me through the symptoms, causes and treatment plan every step of the way. He has been great every time I have seen him, the consistency in who you see is important for me as well as after work appointments or weekends so all this flexibility has been of great benefit.”

Fantastic Service

“Fantastic service and excellent staff. I’ve been going to Skelian for probably more than 10 years now. I’m tall and my job involves a lot of sitting both of which are often causes of back pain. I go at least once every 3 months for preventative maintenance and I always walk out feeling 6 inches taller. Crucially my back rarely gives me any grief now and when it does the team are on hand to sort it out. All treatment is explained in ways that are easy to understand.”

Wish I could give more than 5 stars

“Can’t recommend Skelian enough. For a chiropractor cheltenham direction this is by far, the very best near me. As a farmer my work is very physical and I was suffering with sciatica and shoulder pain. Skelian were very professional and gave me an idea of how fast treatment would be and the realistic expectations, and over time my problems are almost gone. All the treatment was very discreet too and great to know they take patient confidentiality seriously. Wish I could give more than 5 stars. Thanks.”

Highly recommended

“I have been going to the Skelian Clinic for more years than I care to remember both for general ‘maintenance’ tweaks and also occasionally for a specific problem – sciatica being the most recent cause for visiting. Without exception, every member of staff is friendly, welcoming and professional. The fees are reasonable and I have always felt that I have been given enough time for treatment. Since Covid the staff have been scrupulous about hygiene and I have always felt very comfortable continuing to use their services. I see Victoria West and she has worked wonders on me on more than one occasion. Highly recommended.”

Visibly see the improvement

“I’ve been seeing the lovely Alex for just two and a half weeks with a neck/shoulder pain issue I’ve had for many years. I was previously told that it was genetics and there were things we could do to mitigate the pain but it would always be there more or less. Since seeing Alex, I not only am virtually pain free but I can visibly see the improvement. I never thought that would be possible and can’t thank him enough.

He’s also the first person to explain exactly what the issue was and is going to show me how I can strengthen the right muscles to keep the issue from reoccurring which gives me hope that I will remain pain free.”

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I have never felt so relaxed

“Have only just begun going to Skelian, 3 treatments for my back and neck so far. I must say that Victoria West is amazing. I have never felt so relaxed and in less pain. Would give 6 stars if I could.”

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“Jonathan was attentive, caring and sympathetic about my frozen shoulder. He explained clearly with the ultrasound where the pain was and reassured me that there was no underlying issues. The agreed result was for me to have a Corticosteroid Injection to stop the pain that I have been suffering with for the last 3 months. Now I can let my shoulder heal without the excruciating pain that I had been suffering and finally start exercising again to hopefully speed up the recovery.”

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“I’ve been seeing Ellie for a few months now and look forward to the treatment each time. I’ve been suffering with my back for a few years, and previous physio treatment hasn’t done much for me. As soon as I started with Ellie, my recovery was noticeable in the matter of weeks. I’m now able to do simple tasks that I previously couldn’t. Couldn’t recommend Ellie or Skelian enough, or thank them for what they have done to aid my recovery :)”

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