Health Corner

Have you ever experienced stabbing pain and discomfort in your heel when getting out of bed? If you need to stand for long periods or are overweight, this is likely familiar and may be a sign of plantar fasciitis. This condition results from overuse or injury to the plantar fascia, leading to acute or chronic inflammation. Besides taking anti-inflammatory and pain medications, physical therapy and stretching exercises can help speed recovery.

Why does plantar fasciitis occur?
The fan-shaped plantar fascia is a thick, elastic fibrous tissue attaching to the five metatarsal bones at the front and to the inside of the heel bone at the back. It pulls the foot and heel together to form the arch. The plantar fascia supports the arch, absorbs shock during walking, and provides elasticity and torsion. Inflammation occurs due to:

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

• Flat feet cause excessive strain on the plantar fascia.

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

• Spinal or pelvic issues like leg length discrepancy or lumbar disc herniation cause uneven weight-bearing on legs.

What are the symptoms?
Painful stabbing sensation in the heel when getting out of bed, intermittent pain while walking that lessens after about 30 minutes but worsens after walking 2–3 hours, swelling and tenderness on the inner sole.

• Physical therapy treatment:
  Along with medications or steroid injections prescribed by doctors, physical therapy accelerates recovery. Physiotherapists assess the condition and provide treatments like magnetic therapy, ultrasound, interferential current, heat and cold therapy: 6-8 sessions for acute cases, 10-12 for chronic, plus stretching exercises.
• Prevention:
  Stretch calf muscles to relax and reduce excess tension on the plantar fascia.
  Examples: wall calf stretch, stair calf stretch.
  Daily care: avoid prolonged standing or walking, minimize barefoot walking, avoid hard flooring, wear cushioned shoes or arch supports, ice heel 15 minutes after walking.

Hong Kong Registered Physiotherapist
This website provides information for educational purposes only.
You should consult your doctor about surgical options and not rely solely on this information.