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When you take your first few steps in the morning do you get severe pain in your heel? Or maybe your heel hurts after your run or after standing all day? The most common reason for this pain is inflammation in the plantar fascia. Plantar fascia is a thick fibrous tissue that runs along the bottom of the foot and allows your foot to become a rigid lever so that during walking or running you are able to propel yourself forward.

The stabbing burning pain occurs usually in the morning because the fascia tightens overnight. Then those first few steps in the morning are painful as the tight fascia pulls away from the bone where the inflammation occurs.

What are the Signs and Symptoms of Plantar Fasciitis?

It usually develops gradually but usually there is an event, such as a long day of prolonged standing, which pushes the inflammation to the point that pain is registered in your brain. And although it can affect both feet it more often strikes one foot at a time.

Most of our patients will complain of a sharp pain on the inside and bottom of the heel. This pain is worse with the first few steps after getting out of bed, or when climbing stairs, whilst standing on tiptoes, or finally after standing for long periods of time particularly on concrete flooring.

What causes Plantar Fasciitis?

As mentioned above the function of the fascia is to enable the foot to become a rigid lever, as well as it acts as a shock absorber and to support the arch.

When the tension on the fascia is too great small tears occur, which then become irritated and inflamed. This then leads to pain.


The activities to watch out for are:


  • Overload of the fascia through an aggressive new training regimen for runners or walkers, or a new job where you have to stand for prolonged periods of time on a hard surface.
  • Some forms of arthritis can cause inflammation in the tendons in the bottom of your foot.
  • Diabetes can increase your chances of having plantar fasciitis.
  • Poor foot mechanics where the arch of your foot is stressed by having an abnormal pattern of walking and/or having weak and tight foot and lower leg musculature which increases the stress on the fascia.
  • Poor footwear, which has limited arch support and the ability to absorb the forces from the ground into your lower legs as your foot contacts the ground, can increase the likelihood of developing this condition.


What can you do if you have Plantar Fasciitis?

  • Purchase good supporting footwear and depending on the mobility of your foot, either off the shelf or custom made foot orthotics may be helpful.
  • Occasionally people try night splints which attach to your calf and this holds the Achilles and the plantar fascia in a stretched position.
  • Physiotherapy is often helpful to get assessment of the mechanics of your lower body and then find out what would be the best approach to take in dealing with this condition. They will also instruct you on a series of exercises to stretch the plantar fascia and to strengthen the weak muscles in the lower leg as well as some self care tips on what you can do. They may also use manual therapy, taping and dry needling/IMS to release tight tissue and improve the mechanics of the lower leg. This will all be so that you can be back out there on your feet enjoying whatever you love to do as soon as you can.