Plantar Fascitiis

Experiencing sharp heel pain when you first get out of bed or after sitting for a while? Plantar fasciitis, commonly referred to as plantar heel pain, can make walking, exercising and everyday activities quite uncomfortable. The good news is that education, appropriate activity modification and targeted exercise can help manage symptoms and improve function.

What is plantar fasciitis?

The plantar fascia is a thick band of connective tissue running along the bottom of your foot, helping support the arch and absorb forces during walking and running. Plantar fasciitis involves changes in this tissue that can contribute to persistent heel pain.

Common symptoms include:

· Sharp pain with the first steps in the morning.

· Heel pain after prolonged sitting or rest.

· Discomfort during walking, running or prolonged standing.

· Pain that increases after periods of increased activity.

Symptoms can develop when the demands placed on the foot exceed its current capacity, particularly following sudden increases in walking, running or exercise. Other contributing factors may include calf muscle tightness, foot and ankle strength, footwear and prolonged periods of standing.

What does the research recommend?

A systematic review published in the British Journal of Sports Medicine in 2021 examined the evidence for managing plantar heel pain. It is recommended a core approach combining education, plantar fascia stretching and foot taping, with additional treatments considered when symptoms persist. These findings highlight the importance of addressing both symptoms and the foot's capacity to tolerate everyday loads.

Practical tips to manage symptoms:

Manage your activity: Temporarily modify activities that significantly aggravate your heel pain. Gradually increase walking, running and exercise as your symptoms and tolerance improve, rather than stopping all movement.

Stretch regularly: Gentle plantar fascia and calf stretching may help reduce pain and improve comfort, particularly during the first steps in the morning.

Build strength gradually: Progressive strengthening of the foot, ankle and calf muscles can improve your capacity for walking, running and other daily activities.

Choose comfortable footwear: Supportive, comfortable shoes may help reduce discomfort during daily activities. Avoid sudden changes in footwear or training volume if your symptoms are sensitive.

Be consistent: Recovery can take several weeks or longer. Monitoring how your heel responds during activity and the following morning can help guide adjustments to your exercise routine.

How can an Accredited Exercise Physiologist help?

An Accredited Exercise Physiologist (AEP) can assess your functional limitations and develop an individualised exercise program based on your symptoms, activity levels and goals.

At Exercise Physiology Brisbane, an AEP can help you manage training loads, improve foot and lower-limb strength, progress exercises appropriately and build confidence when returning to walking, running or gym training.

Your program can be adjusted as your symptoms and capacity change, helping you work towards your goals without unnecessarily avoiding physical activity.

In summary, plantar fasciitis can be frustrating, but you do not necessarily need to stop moving altogether. Education, activity modification, stretching and progressive strengthening can help manage symptoms and support your return to the activities you enjoy.

Need support with persistent heel pain? Contact Exercise Physiology Brisbane to discuss how an individualised exercise program can support your recovery.

Further reading :

Morrissey et al. (2021): Management of plantar heel pain — a best practice guide informed by a systematic review · 2023 Clinical Practice Guidelines: Heel Pain – Plantar Fasciitis