Plantar heel pain (also commonly referred to as Plantar Fasciitis or Fasciopathy) is an umbrella term characterised by pain which is generally located on the underside of the foot and/or heel. It affects about 4 - 7% of the general population over their lifetime and up to 20% of an athletic or highly active population.
Plantar heel pain is usually felt with the first few steps in the morning or weight bearing tasks particularly after a period of inactivity.
About 80% of people will have resolution of symptoms within 12 months without seeking any treatment. Of those who seek care conservatively (from a physiotherapist or other clinician), we expect to see about 90% resolution.
A recent systematic review done by Morrisey et al., 2021 - looked at what the current best management of plantar heel pain is. This was a big review based on current literature and expert opinion. Below is a chart of best practice guidelines.
Image source: Morissey et al., 2021
Best Practice Management is from a physiotherapeutic intervention. This involves education, plantar fascia stretching and taping of the heel - and an opportunity to explore load management, pain education, related conditions and footwear advice.
Waist girth, ankle plantar flexor (calf muscle) strength, multisite pain, and pain catastrophizing (thinking awful, worrying, negative thoughts about the nature of your pain) were also associated with Plantar Heel Pain – Our physiotherapist can provide advice and management regarding these issues.
During a physiotherapy intervention you will work with the clinician to formulate the best options for you. With many potential contributors to your pain it is our job to help you identify what are the most addressable factors.
References
- Morrissey et al., 2021 - Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values
- Riel et al., 2018 - The Effect of Isometric Exercise on Pain in Individuals with Plantar Fasciopathy: a randomized crossover trial.
- Rogers et al., 2021 - Chronic Plantar Heel Pain Is Principally Associated With Waist Girth (Systemic) and Pain (Central) Factors, Not Foot Factors: A Case-Control Study.
- Salvioli et al., 2017 - The effectiveness of conservative, non-pharmacological treatment for plantar heel pain: A systematic review with meta-analysis
- Whittaker et al., 2017 - Foot orthoses for plantar heel pain: a systematic review and meta-analysis