Plantar Fasciitis

Plantar Fasciitis Overview

Plantar Fasciitis is one of the most common causes of heel pain. It occurs when the plantar fascia—a thick band of tissue that supports the arch of your foot—becomes irritated or inflamed. This condition often leads to pain on the bottom of the heel, particularly with the first steps in the morning or after periods of rest.

Plantar Fasciitis Symptoms and Diagnosis

Symptoms of plantar fasciitis typically include:

• Sharp or stabbing pain at the base of the heel

• Pain on standing after periods of rest

• Discomfort that improves with activity but worsens with prolonged standing or walking

• Tenderness to touch in the heel or arch area

Diagnosis is usually made based on your symptoms and a clinical examination. X-rays, ultrasound or MRI may be used to rule out other causes of heel pain.

Plantar Fasciitis Causes

There are several contributing factors that can lead to plantar fasciitis, including:

• Repetitive strain from walking, running, or standing for long periods

• Tight calf muscles or Achilles tendon

• Poorly cushioned or unsupportive footwear

• Being overweight or recent weight gain

• Foot structure abnormalities, such as flat feet or high arches

Plantar Fasciitis Treatment and Prevention

Initial treatment is usually non-surgical and may include:

• Wearing well-cushioned, supportive footwear

• Stretching exercises for the calf and plantar fascia

• Ice therapy to reduce pain and inflammation

• Anti-inflammatory medication such as ibuprofen

• Orthotics or insoles to offload pressure from the heel

• Night splints to gently stretch the fascia during sleep

Injection Therapy

In persistent cases, Mr Hester may recommend ultrasound-guided steroid injections to reduce inflammation and improve symptoms.

Plantar Fasciitis Surgery

Surgery is considered only after several months of failed non-operative treatment. The most commonly performed procedure is a proximal medial head of gastrocnemius recession.

This surgery targets tightness in the calf muscle (gastrocnemius), which contributes to excessive strain on the plantar fascia. By lengthening the muscle, the tension on the fascia is reduced, helping to relieve pain and improve flexibility.

The procedure is performed as a day case under general or local anaesthetic, through a small incision behind the knee.

Risks of surgery may include:

• Pain

• Bleeding

• Infection

• Scarring

• Damage to nearby nerves or blood vessels

• Deep vein thrombosis (DVT) or pulmonary embolism (PE)

• Failure to improve symptoms

• Need for further surgery

Mr Hester will discuss these risks with you before any procedure and ensure that surgery is appropriate for your condition.

Plantar Fasciitis Surgery Recovery

Following surgery, you will be advised to rest and elevate the foot for the first two weeks. A protective dressing or boot will be applied, and it is important to keep the area dry. At two weeks, your wound will be reviewed, and sutures will be trimmed or removed.

You may begin walking in supportive trainers between weeks two and four, and start gentle stretching exercises. Most patients return to regular activity between six to twelve weeks, with running and higher impact sports resumed from twelve weeks onwards if pain-free.

Expected Recovery Timeline

0–2 weeks

Rest, foot elevated. Protective dressing or boot. No weight-bearing or minimal walking.

2 weeks

Wound review. Sutures trimmed or removed. Transition into light footwear as advised.

2–4 weeks

Begin walking in wide-fitting or supportive trainers. Gentle stretching.

4–6 weeks

Increased walking and daily activity. Residual swelling or discomfort may persist.

6–12 weeks

Return to most normal activity. Pain and stiffness typically reduce.

12 weeks+

Running and impact activities may resume if fully recovered and pain-free.