Heel Pain /
Plantar Fasciitis

What is the Plantar Fascia?
  • The plantar fascia is a thick fibrous ligament that runs under the foot from the heel bone and fans under the arch to attach to the base of the toes
  • The function of the plantar fascia is to help arch the foot by tightening like a pulley as the toes bend during push-off with walking or running
  • It acts as a natural shock absorbing mechanism
  • It is not very elastic so has a limited ability to stretch or elongate
What is a Heel Spur?
  • A Heel Spur is a bony growth on underside of the heel bone (calcaneus)
  • It is a type of calcification thought to develop as a response to constant traction and pulling of the plantar fascia on the heel bone
  • An x-ray will clearly show a heel spur
  • The spur is not painful, the pain is caused because of the inflammation of soft tissue around the heel
  • Many people suffer with Plantar Fasciitis and do not have a heel spur and vice-versa
What is Plantar Fasciitis?
  • Plantar Fasciitis is also referred to as Heel Spur Syndrome
  • It is a very common condition seen by Podiatrist – approximately 1 in 10 people affected in their lifetime
  • It is susceptible to reoccur
  • It is an inflammation of the plantar fascia resulting in irritation and pain
  • When too much stress is placed on the plantar fascia then micro-tearing will occur
  • Typically, pain is in and around the heel where the plantar fascia attaches. Some people experience pain under the arch of the foot also
  • It can affect one or both heels
  • The pain typically feels like a ‘bruised’ heel
  • Generally worse in the morning on getting out of bed – during rest the plantar fascia shortens and tightens
  • Improves as the foot warms up with walking as the plantar fascia becomes more flexible
  • Pain during the day from periods of rest to standing
  • Walking long distances or increased standing is likely to cause the pain to return

  • Strain on the plantar fascia can occur either by acute or chronic injuries
  • Acute injury to the plantar fascia is where there is an incident of a stretch injury to the arch of the foot
  • Chronic injury to the plantar fascia is repetitive strain and can be the result of many factors including:
    - Overuse: sports, running, walking or standing for long periods
    - Age: more common in people over 40 years of age
    - Weight gain: more pressure on bones, joints, muscles and ligaments
    - Occupation: jobs with a lot of walking or standing on hard floors
    - Poor footwear: with inadequate support
    - Foot Biomechanics: both high arched and low arched or pronated feet can be prone to Plantar Fasciitis


Get Treatment Early to Prevent Plantar Fasciitis Becoming a Chronic Condition

Effective treatment is aimed at reducing strain and therefore inflammation in the plantar fascia. This can be done by:

  • Strapping – to support the arch and take load from the plantar fascia and the heel
  • Compressive foot sleeves – help reduce inflammation
  • Stretching – of the plantar fascia and calves
  • Strengthening – of the calf muscles and internal muscles of the foot
  • Footwear – avoid being barefoot or wearing soft shoes or thongs. Wear more supportive lace ups or runners
  • Orthotics – your Podiatrist can discuss the most effective orthotic device to improve your foot biomechanics to help offload the plantar fascia

It is also important to reduce the inflammation in the plantar fascia. This can be done by:

  • Rest – with feet elevated to reduce swelling
  • Cold packs – to constrict blood vessels to reduce blood flow and inflammation
  • Anti-inflammatory medication – seek medical advice
  • Cortisone injections – can aid in the reduction of inflammation. Beware as can cause tissue and fat pad atrophy

Dry needling/Shock wave therapy can be useful in chronic cases of Plantar Fasciitis to help increase blood flow to the area and stimulate the repair process of the ligament