Plantar fasciitis and heel spurs

What is plantar fasciitis?

It is an irritation or inflammation of the plantar fascia on the bottom of the foot.

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What is the plantar fascia?

It is a structure under the foot that is like a ligament. It attaches from the heel to the toes and acts as a support for the arch of the foot, allowing us to put weight on the foot.

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What is the difference between plantar fasciitis, plantar fasciopathy, and a heel spur?

• We will refer to it as fasciitis if there is inflammation in the plantar fascia.
• We will refer to it as fasciopathy when pain is present, but there is no inflammation. Therefore, we are talking about an irritation of the plantar fascia rather than inflammation.
• A heel spur is simply a calcification of the attachment of the plantar fascia on the heel. The heel spur does not itself cause the pain. See the blog article on the myths associated with heel spurs (coming soon).

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« So, whether you have a heel spur, plantar fasciitis, or plantar fasciopathy, it's all the same since the management is very similar. We will use the term plantar fasciitis here to talk about it since it is the most well-known term »

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What are the causes of plantar fasciitis?

This is caused by:

• A recent increase in weight-bearing activities (standing, walking, running)

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Here are some classic examples of the development of this pathology:

• Going to the south and taking long walks in the sand barefoot when you are used to always wearing shoes
• Starting to wear sandals at the beginning of the summer when you have been wearing thick, well-cushioned shoes all winter
• Resuming running without properly progressing your training.
• Increasing running training volume or changing running shoes without a proper transition.
• Starting a new job that requires standing all day when you are used to working while seated.

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What are the risk factors for developing plantar fasciitis?

The following factors increase the risk of developing plantar fasciitis:

• Lack of ankle flexibility in dorsiflexion (lifting the foot up).
• Weakness in the foot muscles that control our arch.
• A high body mass index (BMI) in non-athletic people.
• Having a job that requires a lot of standing.

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What are the symptoms of plantar fasciitis?

The most common symptoms are:

• Pain that appears gradually in the heel or along the arch of the foot.
• The pain is often increased by:
  
  • Standing for long periods.
  • Walking for long periods.
  • Running
• The pain is worse in the morning with the first steps and improves with movement.
• The pain returns when getting up after being still for a long time.
• The pain is less intense when wearing shoes or high heels.

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How is plantar fasciitis diagnosed?

Diagnosis is possible through a review of your symptom history and a clinical examination.

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When should I see a physiotherapist for plantar fasciitis?

You should consult a physiotherapist if you have symptoms as described above or if your doctor has already ruled out any other cause that may be responsible for your pain.

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You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

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What physiotherapy treatments are available for plantar fasciitis?

Your physiotherapist will conduct an assessment to determine the cause of your plantar fasciitis by evaluating the following:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your strength and stability

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Based on the assessment results, your physiotherapist will:

• Mobilize your nerve with specific treatment techniques.

• Provide you with specific exercises to retrain the strength and stability of your foot.
• Provide you with specific exercises to learn how to properly control your movements and desensitize your nerve.
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your posture and movements.

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What can I do at home for plantar fasciitis?

Temporarily reduce the amount of time you spend doing activities that cause too much pain, and then gradually resume doing them afterwards.

Here are some tips that may help:

• Engage in activities that reduce stress on the area, such as swimming.
• Take frequent but short breaks while sitting if the pain increases when you walk or stand for long periods.
• Roll a ball under your foot without causing significant pain to relax the muscles in the sole of your foot.
• If the pain is recent (less than two weeks), you can temporarily use a prefabricated orthotic purchased at a pharmacy to give your foot some rest.
• Wear shoes with thicker soles temporarily.

If you don't see any improvement after 10 days, you should consult a physiotherapist.

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If you are a runner, refer to the blog post on running (link to come) for specific running tips.

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To learn more...

You can listen to the podcast PARLE-MOI DE SANTÉ created by one of our physiotherapists, Alexis Gougeon.

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Episode #1 discusses the prevention and treatment of running injuries.

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Find the episode on YouTube:

Click below to listen to episodes on podcast platforms:

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Sources

• Martin RL, Davenport TE, Reischl SF, McPoil TG, Matheson JW, Wukich DK, McDonough CM, Altman RD, Beattie P, Cornwall M, Davis I. Heel pain—plantar fasciitis: revision 2014. Journal of Orthopaedic & Sports Physical Therapy. 2014 Nov;44(11):A1-33.
• American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain J Foot Ankle Surg. 2017 Dec 25. pii: S1067-2516
• Orthotics Compared to Conventional Therapy and Other Non-Surgical Treatments for Plantar Fasciitis J Okla State Med Assoc. 2015 December ; 108(12): 596–598.

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