The key to success is getting the right treatment

Advice for Plantar Fasciitis or Plantar Heel Pain (PHP)

Having pain in your foot can be very hard to get away from or relieve since we spend so much time on our feet. If you have developed pain in the arch of your foot or in your heel it may be a condition called “Plantar fasciitis” or “Plantar Heel Pain” (PHP). As a physiotherapist with a special interest in biomechanics of the foot and ankle, I have treated A LOT of plantar fasciitis. It can be a difficult condition to resolve, but with the correct treatment, you can get amazing results and put your foot pain behind you.


What causes plantar fasciitis?


It is caused by an over-stretching or over-stressing of the ‘plantar fascia’, which is a broad band of tissue that spans the bottom of the foot and contributes to the formation of the arch. It is often caused by an increase or change in activity, weight gain, or due to faulty biomechanics (alignment) of the foot and ankle.


What are the symptoms?


The pain is felt in the arch of the foot and/or in the heel. These symptoms are often worse first thing in the morning as a result of this tissue tightening up overnight. It can also cause you to limp and prevent you from doing your sport.


Occasionally, the pain is felt in the foot or heel but is actually originating from somewhere else. Some back conditions for example can give foot or heel pain even in the absence of back pain. Our physiotherapists will thoroughly assess you at your first visit to identify the cause of your heel pain and ensure that they are treating the back as well if needed.


How can it be treated?


Because it is often worse in the morning on waking, it is recommended to do some exercises and stretches before getting out of bed. It is also advised to do them when sitting for prolonged periods of time and before and after sport. Your physiotherapist can advise you in which exercises to do and how to do them. Sometimes, people find that wearing a ‘night splint’ to prevent the tissue from tightening up overnight is useful.


A major cause of plantar fasciitis is tight calf muscles. Therefore, proper and regular stretching of the calves (gastrocnemius muscles) is important.


Because inappropriate footwear and/or faulty foot biomechanics (malalignment) can contribute to plantar fasciitis, an evaluation of your footwear and foot alignment is recommended. Over-pronation is often a cause of this condition and therefore an anti-pronation trainer with a firm heel counter, a medial foot bridge and good arch support can help to reduce your symptoms.


A full biomechanical evaluation and a prescription for a specialised custom-made insoles called functional foot orthotics may be needed. This is proven to be one of the most effective ways to resolve plantar fasciitis. Over the years, I have found it crucial with my patients, used in conjunction with other physiotherapy treatments such as soft tissue massage, mobilisations, ultrasound, stretches, strengthening, footwear advice, and gait re-training.


If you are suffering with plantar fasciitis, please feel free to get in touch to discuss possible treatment options at PhysiOptima.


Kristin Giussani, Biomechanics Expert, Foot & Ankle, PhysiOptima

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