What Is Plantar Fasciopathy & How Do I Get Better?

  • Are you suffering from a sharp and achy pain under the heel of the foot, often worse when walking barefoot?
  • Are you experiencing pain in prolonged standing, or difficulty walking/running long distances?
  • Pain that is worse in the morning when taking the first few steps out of bed or after a long period of rest?

You are likely experiencing Plantar Fasciopathy.

The plantar fascia is a tough fibrous tissue that runs under your foot to serve as load distribution and maintaining stability when we are walking or running. The pain can be acute or chronic, meaning it can have come on suddenly or you may have been experiencing this for months. This can be a debilitating condition affecting up to 10-15% of the population in all ages, but is most commonly experienced in the female population aged 40-60 years.

Unfortunately plantar fasciopathy can last up to or greater than 6 months….although the good news is that approximately 90% of cases are treated successfully with conservative care and physiotherapeutic rehabilitation (which means using non-invasive techniques). Your physiotherapist can help guide you through your journey to optimise a safe return to your daily activities and return to sport.

Rest - As physiotherapists, when we talk about ‘rest’, we do not mean sitting down for a week as this can lead to a poorer outcome. What we actually mean is rest from the aggravating activity, for example, reducing your standing time or holding off running for 2 weeks. We always work closely with you to get back to your goals.

Ice – this is a quick and cost-effective way to help reduce acute pain. Evidence suggests ice is an effective treatment therapy for short-term pain relief.

Taping - taping assists with passive mechanical arch support and has been found to be effective in the short term. Evidence also suggests taping can be more effective in reducing pain when combined with stretching.

Soft Tissue Release - this can be performed by your physiotherapist and we can teach you techniques that you can perform at home using a trigger release ball. We often advise our clients to place a bottle of water in the freezer to help reduce pain with self-massage. No studies have proven its effectiveness; however, physiotherapists and patients have reported good clinical feedback.

Stretching – this treatment is evidence based, cost-free and can be done from the comfort of your own home. Short calf muscles have been shown to be a predisposing factor for getting pain in the first place, so it is important to address this issue. Evidence recommends a minimum of 3 times a day with at least 10 repetitions of each stretch, held for 10 to 30 seconds.

Strength Training - this is a longer-term preventative treatment strategy. Strengthening the structures around the foot and ankle will help support the joint and improve your functional movements.

Proprioceptive exercises – when suffering from a foot injury it is important to re-educate the body’s ability to balance, improve coordination and agility.

Addressing your Risk Factors - this is a really important one and can include obesity, standing for long periods on hard surfaces, poor foot biomechanics, poor shoe fitting, age and sex. It is not possible to address your age and sex, however you can make changes to your weight, your standing habits and foot biomechanics with appropriate training.

Berbrayer, D. and Fredericson, M. (2014). Update on Evidence-Based Treatments for Plantar Fasciopathy. PM&R, 6(2), pp.159-169.

Ken Tan