Author: Dr.Reneesh (Consultant Orthopedic Surgeon – WELLKINS Medical Centre)

The plantar fascia, a thick band of connective tissue located on the sole of the foot, plays a crucial role in supporting the arch and absorbing shock during walking. Repetitive strain or microtears can lead to inflammation of this tissue, a condition known as plantar fasciitis, which commonly causes heel pain and stiffness.

 What is Plantar Fasciitis?

The plantar fascia is a thick band of connective tissue that runs along the bottom of the foot, from the heel to the toes. It supports the arch and absorbs shock during walking. Plantar fasciitis occurs when this tissue becomes inflamed due to repetitive strain or microtears, leading to heel pain and stiffness.

Causes of Plantar Fasciitis

Several factors contribute to the development of plantar fasciitis, including:
Overuse or Repetitive Stress – Excessive walking, running, or standing (common in athletes, nurses, teachers, and retail workers).
Foot Mechanics – Flat feet (pes planus), high arches (pes cavus), or abnormal gait patterns.
Tight Achilles Tendon or Calf Muscles – Limits ankle flexibility, increasing strain on the plantar fascia.
Obesity – Extra weight puts added pressure on the plantar fascia.
Improper Footwear – Worn-out shoes or lack of arch support.
Age – Most common between ages 40-60 due to decreased tissue elasticity.
Sudden Increase in Activity – Starting a new exercise regimen without proper conditioning.

Symptoms of Plantar Fasciitis

The hallmark symptom is sharp, stabbing heel pain, typically:

1.Worst with the first steps in the morning or after prolonged rest.
2.Improves with movement but may return after long periods of standing or walking.
3.Localized near the inner side of the heel (medial calcaneal tubercle).
4.May cause stiffness and tenderness along the arch.

Diagnosis of Plantar Fasciitis at WELLKINS Medical Centre 

As an orthopedic surgeon, I diagnose plantar fasciitis based on:

Medical History & Physical Exam – Checking for tenderness along the plantar fascia and ruling out other conditions (e.g., stress fractures, nerve entrapment).

Imaging (if needed) –

X-rays to rule out heel spurs (though spurs don’t always cause pain).
Ultrasound or MRI if there’s suspicion of a fascia tear or other soft tissue pathology.
Blood Investigations – CBC, CRP,  ESR

Differential Diagnoses:

Heel pad atrophy (thinning of fat cushion in the heel).
Tarsal tunnel syndrome (nerve compression).
Achilles tendinitis (pain higher up, near the back of the heel).

Potential Complications of Plantar Fasciitis

If left untreated, plantar fasciitis can lead to:
Chronic heel pain that interferes with daily activities.
Gait abnormalities (limping or altered walking patterns), leading to knee, hip, or back pain.
Plantar fascia rupture (rare, but possible with excessive steroid injections or overstretching).

Prognosis & Recovery

The good news? Most patients recover with conservative treatments within 6-12 months. Key factors affecting prognosis:

Early intervention (rest, stretching, proper footwear) speeds recovery.
Compliance with physical therapy improves outcomes.
Weight management reduces recurrence risk.
Surgical Options (Rarely Needed – <5% of Cases):
Plantar Fascia Release (partial cutting of the fascia to relieve tension).
Gastrocnemius Recession (lengthening calf muscles to reduce strain).

Plantar fasciitis is a highly treatable condition, but patience and consistency are key. If you’re struggling with persistent heel pain, consult an Orthopedic specialist to tailor a treatment plan for your needs.

Read more about the orthopedic services at wellkins here: https://wellkins.com/orthopedics/