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Waking up in the morning should be the starting point of a new day full of possibilities. However, if the mere process of getting out of bed and standing up is associated with excruciating pain in the heel, it is enough to spoil anyone’s day. The pain usually eases after a couple of minutes, but in severe cases can persist all day and be painful on every step.

The plantar fascia is a long and strong ligament that runs from the base of the heel and joins the base of the toes. It is a very tight structure and its main function is to help maintain the arch of the foot.

When the foot arch starts to collapse because of muscle weakness, excess weight or changes in walking pattern, the plantar fascia ligament can become over stretched and may get some micro tears and create inflammation. This creates pain with walking, especially in the morning or after been seated for a long time.

The body can try and compensate for this by growing a small bone out from the heel to decrease the amount of stretch on the plantar fascia. This may require surgery at some stage, but conservative treatment and rehab should be attempted first.

Over stretching of the plantar ligament causes micro trauma
Over stretching of the plantar ligament causes micro trauma

Advice, Treatment and Prognosis for Plantar Fasciitis

1. Wear comfortable and supportive shoes, which may require an insert or arch support. High heels can make this condition worse.

2. Regular stretching of the calf muscle helps to put the heel in the correct position, thus decreasing strain on the plantar fascia

3. Ice massage – Take a polystyrene cup and fill with water and freeze. Once frozen, tear off the top 2 cm of the cup to expose the ice. Hold the cup and massage the bottom of the foot for 5 mins

4. Start moving and stretching the feet in bed before you take the first step. This will decrease the pain in the morning.

5. Physiotherapy treatment will involve soft tissue massage, passive stretching ultrasound and shockwave therapy, nerve mobilization, taping and strengthening

Prognosis: Varies according to the nature and severity of the condition. Expect a recovery time ranging from 2-6 weeks. In some cases a cortisone injection may be required and for a non responsive bone spur surgery may be indicated.

good shoes are vital to good foot health
good shoes are vital to good foot health