Plantar 

Fasciitis

Pain Underfoot

Also called Plantar fasciopathy

Around 1 in 10 people will suffer with Plantar fasciopathy (PF) in their lifetime(1).  This is usually a slow onset.  Often described as an overuse injury it occurs when the tough connective tissue under the foot starts to hurt. This can occur in runners as well as those with more sedentry lives.

The risk factors are not clear although some evidence suggests high BMI may be a factor in non-athletic population(2). The evidence for best treatment is not clear (3), but several options are worth perusing. When exercises in which you remain in a static hold (isometric) are compared with moving exercises (isotonic) and just plain walking, on average they are similarly effective (4).  However, within each group each participant had very different outcomes.   This suggests that in practice we have to work out what works best for you. Recent research has suggested that good advice and a heel cup maybe as good as exercises and corticosteroid injections combined(1).

If you think you may have plantar fasciitis, we can help.

1. Riel, H., Vicenzino, B., Olesen, J. L., Jensen, M. B., Ehlers, L. H., & Rathleff, M. S. (2023). Does a corticosteroid injection plus exercise or exercise alone add to the effect of patient advice and a heel cup for patients with plantar fasciopathy? A randomised clinical trial. British Journal of Sports Medicine.

2. Franceschi, F., Papalia, R., Paciotti, M., Franceschetti, E., Di Martino, A., Maffulli, N., & Denaro, V. (2014). Obesity as a risk factor for tendinopathy: a systematic review. International journal of endocrinology, 2014.

3. Rhim, H. C., Kwon, J., Park, J., Borg-Stein, J., & Tenforde, A. S. (2021). A Systematic Review of Systematic Reviews on the Epidemiology, Evaluation, and Treatment of Plantar Fasciitis. Life (Basel, Switzerland), 11(12), 1287. https://doi.org/10.3390/life11121287

 4. Riel H, Vicenzino B, Jensen MB, Olesen JL, Holden S, Rathleff MS. The effect of isometric exercise on pain in individuals with plantar fasciopathy: A randomized crossover trial. Scand J Med Sci Sports. 2018; 28: 2643–2650. https://doi.org/10.1111/sms.13296