Health Corner

Have you ever experienced stabbing pain in your heel when getting out of bed? If you often stand for long periods or are overweight, this sensation may be familiar and could be a sign of plantar fasciitis. This condition is caused by overuse or injury of the plantar fascia, leading to acute or chronic inflammation. Along with taking anti-inflammatory and pain medication, physical therapy and stretching exercises can promote faster recovery.

Why does plantar fasciitis occur?
The fan-shaped plantar fascia is made of thick elastic fibrous tissue. It attaches at the front to the five metatarsal bones and at the back to the inner heel bone, tightening the foot and heel to form the arch. The plantar fascia helps maintain the foot arch, absorb shocks during walking, and provide elasticity and torsion. However, inflammation can be caused by:

• Prolonged standing, obesity, or excessive walking leading to abnormal foot pressure and overuse or injury of the plantar fascia, sometimes thinning the heel fat pad, causing acute or chronic inflammation.

• Flat feet reduce the arch height, causing overuse and inflammation.

• Some patients with heel bone spurs have thicker plantar fascia than usual.

• Spinal or pelvic issues, such as unequal leg length or lumbar disc herniation, cause uneven weight-bearing on the legs.

What are the symptoms of plantar fasciitis?
Symptoms are distinct, including stabbing heel pain when putting weight on the foot after getting out of bed, intermittent pain during walking which may lessen after about 30 minutes but worsens after walking for two to three hours, and swelling with tenderness on the inner plantar side.

How is plantar fasciitis treated with physical therapy?
Besides medications and steroid injections prescribed by doctors for pain and inflammation, physical therapy accelerates recovery. Physiotherapists assess the patient’s condition and provide individualized treatment depending on acute or chronic phase, including magnetic therapy, ultrasound, interferential current, heat, and cold therapy. Six to eight sessions are typical for acute cases, while chronic cases may require 10 to 12 sessions, supplemented with appropriate stretching exercises.

How can I prevent plantar fasciitis?
Calf stretches relax calf muscles and reduce excessive pull on the plantar fascia. For example, support yourself with both hands on a wall, place the affected leg behind you, and lean forward to feel a gentle stretch. To stretch calves, stand on the edge of stairs with the front of both feet while keeping knees straight, lower the heels below stair level, and push the body downward.

Daily care and prevention include:

• Avoid prolonged standing and walking to reduce foot pressure.

• Minimize barefoot walking.

• Avoid walking on hard floors or forceful stepping.

• Wear cushioned shoes or use appropriate arch-support insoles.

• After walking, apply ice to the heel for about 15 minutes to diminish inflammation.

Hong Kong Registered Physiotherapist
Information on this website is for educational use only.
You should consult your doctor regarding surgical methods and not rely solely on website information.