This is basic information on plantar fasciopathy and its treatment. It is not a complete guide and a physiotherapist may give you other advice specific for you.

Blue arrow icon.png Speak to your GP or pharmacist for advice on pain relief.

About the plantar fascia

The plantar fascia is a strong band of tissue (a ligament) that runs along the bottom of the foot from the heel to the toes. It supports the arch of the foot and acts as a shock absorber.

Plantar fasciopathy

Plantar fasciopathy is when the band of tissue under the foot becomes thicker and so works less well. It is caused by repeated overloading.

It used to be called plantar fasciitis.

Common symptoms

The common symptom is pain in the bottom of the foot.

  • The pain is usually at the base of the heel but can spread along the bottom of the foot.
  • The pain is usually worse first thing in the morning for the first few steps of the day, or walking after resting.

Who gets it

Anyone can get plantar fasciopathy, but it is more common in:

  • people who are overweight
  • people who are very inactive
  • athletes who train a lot
  • people with tight calf muscles and Achilles tendon
  • people with weak leg or foot muscles
  • people who have lost strength or function after being unwell.

What you can do

The pain usually gets better with time and changes of activity. A combination of treatments are likely to help – see below.

  • Reduce activities that make the pain worse.
  • Wear shoes that support and cushion the foot, such as trainers.
  • Try gel heel pads to cushion the heel. These can be bought at a pharmacy.
  • Ice the foot to ease the pain. Roll the bottom of the foot over a frozen bottle of water. Do this for 3 to 5 minutes a day.
  • Try the exercises shown below.

Exercises

Calf stretches

Calf stretch 1.pngThese exercises help if your calf muscles are tight. Do them every day.

Do not do these exercises if they increase your pain.

  • Stand with the front of your foot on a very small wedge to start with (for example, a thin paperback book). You should feel a gentle pull in the calf muscle or back of knee or ankle.
  • Hold this for 30 seconds.
  • Do this once a day at first. Gradually build to at least twice a day, but then eventually every 3 to 4 hours.
  • Gradually and slowly increase the holding time until you’re doing it for about 3 minutes, at least 2 to 4 times a day.

Next stage

  • Once this feels comfortable, gradually increase the height. For example, move to a thick paperback book and eventually a thicker hardback book.
  • Repeat the cycle (as above) each time before moving up to the next height.
  • Keep your knees straight (pushed back) and stand tall and proud, without your bottom sticking out.
standing with toes on a board to stretch calf
do not lean forward

Strength exercises

Strength exercises are proved to be the best treatment for plantar fasciopathy. As with stretching, increase these gradually.

Do not do these exercises if they increase your pain.


Level 1

  • Standing on tip toes with toes on towelStart with a rolled towel under your big toes and the rest of your feet on the floor.
  • Push up onto your tip toes.
  • Hold for as long as is comfortable, 5 to 30 seconds. Repeat 3 times.
  • Do 3 times a week.

 


Level 2

  • Calf raises on a step, with towel under toesPut a rolled-up towel near the edge of a step.
  • Stand on the step with the ball of the foot on the edge and the towel under the toes. Hold on to something if you need to.
  • Counting slowly to 3, push up onto your toes, standing tall on one leg.
  • Hold for 2 seconds.
  • Slowly lower the heel towards the floor.
  • Repeat 8 to 12 times.
  • Do this 3 times a week.

Contact information

Physiotherapy

Telephone:

020 8934 2510
(Monday to Friday, 9am to 5pm)

Email: Khft.physioop@nhs.net