You might remember that a few months ago I asked for people who suffer from plantar fasciitis to complete a quick survey. Well today we are going to take a look at the results and discuss what it is, how its caused and what can help rehab it. Firstly, I would like to thank everyone who took the time to complete the survey or contact me over social media about plantar fasciitis. Secondly I would like to thank those who got in touch using the website to ask me to look into this, as it’s a condition I know a lot of people suffer from.
So what is plantar fasciitis?
Well before we look into what it actual is we need to know what tissue it affects, the plantar fascia. The plantar fascia is a thick band of tissue that stretches from the heel to the base of the toes. According to The British Medical Association Guide to Sports Injuries (2010) plantar fasciitis is a chronic condition where this thick tissue becomes inflamed causing pain in the foot. It is also not uncommon to see a heel spur when someone with plantar fasciitis is x-rayed, this is a calcium deposit found over the heel bone.
What causes it?
It’s normally caused by movements which involve repetitive stress to the underside of the foot such as running or jumping on a hard surface. I normally see it with athletes who compete in basketball, volleyball or running. However, it is not limited to athletes and I have seen it in a lot of people who are on their feet a lot or have to wear specific safety footwear with poor arch support for their jobs. It normally happens when this repetitive movement/stress to the bottom of the foot causes the toe joints to bend and put pressure on the heel end of the tissue which causes inflammation. You can see from the data collected that it can be caused by a variety of activities, however it seems from those who took part 58% stated that it was walking that caused them to notice it.
What to look out for and how often will it flare up?
Plantar fasciitis causes pain to the underside of the heel and foot. Pain might go away when walking or exercising but will return after, or as we saw above it may remain during exercise. Some of my clients have told me it feels like the underside of their foot has a painful ball or gravel in it or a stabbing pain. They have also stated that it normally feels worse in their first few steps when they wake up or after they have been sat for long periods of time and they sometimes struggle to life their toes up. It can flare up at anytime and it affects people differently but from the data I collected it showed that the majority of plantar fasciitis sufferers (54%) had a flare up every day. Two participants explained that once they had received treatment they had never had a further flare up, however for the majority it will flare up from time to time and will depend on how active you are and how you rehab the injury when it does flare up.
What can you do to help with recovery?
If left untreated it will normally get worse and even lead to pain in your knee, hip and lower back. In the majority of cases I have known about, surgery has not been needed and this is also supported by The British Medical Association Guide to Sports Injuries (2010) who states that without surgery plantar fasciitis should heal within a few months, in fact one participant who took part in the survey told me that they did have surgery but plantar fasciitis did return so they just use various methods to recover when it flares up now. I would always advise clients to seek medical advice before rehabbing it to see how severe it is. If you do not require surgery, there are various exercises that you can do to help. Its important to take it slow and build from there.
To start with I normally get clients to use a golf ball/tennis ball or small hard recovery ball to roll around with the bottom of their foot along with doing some foot stretches such as putting your foot flat on a carpet and making balls then stretching the foot out as much as you can. Once it starts to recover you can add in calf raises, calf stretches and walking pop ups (normal walk then push up onto your toes each step).
However, the most effective way to recover is to use a variety of methods including things like ice and insoles. I put the most common ones on the survey (pain killers, insoles, foot massage, rolling a ball with sole of foot and ice) and from the answers 38% stated they used all of these methods combined to help recovery and not just one method, however this was followed by insoles with 23%.
What does the data show us?
In general it shows us that plantar fasciitis is a long term injury and for most it won’t go away but instead will flare up from time to time. The majority of those who took part in the survey had been suffering from it for under two years (47%) but there were participants who had been suffering with it for over 10 years (7%).
The data also showed that the majority of suffers first notice it when walking, however 18% first noticed it at work. This shows that it's not necessarily just those who participate in sport or running who get it and that it could be down to the type of footwear you wear at work or the type of work you do.
There are, as with all studies, limitations to the data collected. The main one with this type of study is that I only asked four closed questions. Further questioning would be needed to take a more in depth look at things like correlation between plantar fasciitis and age, activity level, sex, etc. The data showed that most discovered they had it when walking, however further questioning would be needed to see if this is their primary way to keep fit or if they also went to the gym, played sports or ran and it just so happened they noticed it when walking. The sample group was 137 participants which might mean some of the outcomes from the questionnaire may have been slightly different with a bigger sample group.
Please note this article is not intended to give advice or guidance on how to manage your own plantar fasciitis, if you think you are suffering from the symptoms seek the advice of your own health care professional.
I would like to finish by thanking you all for taking the time to read my latest article. Don’t forget to follow me on Instagram or enter your email address above to be kept up to date with latest articles and workouts. Please get in touch if there is anything you would like me to look into.
The British Medical Association Guide to Sports Injuries (2010)
Title Images sourced from
(Left) - onehealthcare.co.uk
(Middle) - novusspinecenter.com
(Right) - American Academy of Orthopaedic Surgeons