Plantar fasciitis is a common cause of heel pain and can be quite disabling. It is sometimes resistant to treatment and can persist for months or even years.

Typically the pain is under the heel and is much worse first thing in the morning when the feet are placed on the floor.

After a period of time the severe morning pain settles and the pain eases during the day. It is often worse with prolonged standing or walking on hard surfaces.

It is thought that there is inflammation around the heel where the fibrous tissue in the sole of the foot (the plantar fascia) joins onto the bone. This plantar fascia fibrous tissue becomes quite painful. It is sometimes associated with the so-called heel spur.

The presence of heel spurs on xrays though is not helpful in making the diagnosis. 10% of people have heel spurs without any pain.

In this new article which was a randomised control trial of particular stretches for plantar fasciitis they discussed the history of the complaint. The fascia may be shortening during the night when the feet are off the ground and when the feet are placed on the ground the stretching causes tears. It is thought that when people first place their feet onto the floor after getting up they cause microscopic tearing in the plantar fascia and this causes immediate severe pain.

The idea is that with the stretching done first thing in the morning they are less likely to get any tearing and the condition settles.

It seems that this new type of stretch was effective in 90% of people at two years duration. The study found that 75% of patients had no pain and no limitation of activity. They also didn’t need to see doctors or other therapists.

Instructions on doing the stretches

Cross your legs putting one foot across the other knee. Grab your toes with the other hand and press the sole with your thumb. Pull up only the toes pulling them towards the shin and checking that you could feel the fascia in the sole of the foot going tight. Hold this for a count of 10 and repeat it 10 times, three times per day starting from before the time you get out of bed.

The abstract of the article is here:

Summary of article on treatment for plantar fasciitis