Plantar Fasciitis / Fasciopathy

August 13th, 2022

Plantar Fascia

  • fascia supports arch of foot (normal functions of arch involve efficient distribution of load and propulsive forces) and is made up of tissue known as collagen; as we get older collagen is less elastic and more prone to tearing

Plantar Fasciitis/Fasciopathy

  • very common in general population but more common in those over 40
  • characterized by pain localized to heel; complaint is commonly of sharp pain, worst with first few steps in morning or on rising after prolonged sitting
  • may result either from micro-tearing of fascia and consequent inflammation and restrictive scarring of fascia or structural weakness of collagen tissue without the presence of inflammatory cells
  • common causative findings include excessive pronation of feet during gait and tightness of calf muscles
  • in severe cases condition interferes with work and/or recreation
  • may develop in both feet as a result of compensatory gait from avoidance of painful loading on affected side

Physical Therapy Treatment

  • assessment of foot-ankle biomechanics, gait analysis, and palpation of localized tender area (defining diagnostic finding)
  • application of electrotherapeutic modalities
  • 'stripping' and stretching of plantar fascia, followed by icing
  • passive stretch of tight tissue; active stretches assigned
  • 'low dye' taping provides temporary support to intrinsic muscles and fascia
  • orthotics, designed to support arches while maintaining neutral positioning of feet in weight bearing, may be prescribed
  • night splint may be prescribed to provide constant passive stretch (adjusted to provide serial stretch) on fascia

Other Treatments

  • modification or avoidance of certain activities may be necessary
  • acupuncture may reduce myofascial pain
  • cortisone injection is last resort intervention
  • surgery considered only with persistent, severe symptoms refractory to conservative intervention of at least 6 to 12 months duration


  • resolution of condition usually within one year with conservative (i.e., non-surgical; modalities, exercise, education, +/- orthotics) therapy only

Physio Note: Footwear and Stretches

Certain shoes and walking barefoot can make the pain worse. Inspect your wardrobe of shoes and discard non supportive footwear. Often, in fact, patients complain that pain began after purchase of particular shoes. Do not walk without supportive footwear (no flat-soled footwear, incl slippers, and no barefoot or stocking foot walking) especially during acute phase of condition. Keep supportive footwear at bedside for use on rising

Running in old runners that have worn out can be start of problem. Usual life of a pair of runners is about 300 km so replace them frequently

Your physical therapist can show you what features to look for in selecting appropriate footwear, including runners, slippers, and sandals

Calf muscles are often found to be tight on assessment of plantar fasciitis so regular stretching of Gastrocnemius and Soleus (calf) muscles is recommended