Answer

By Country Walking magazine

Plantar fasciitis is a painful and relatively common foot condition which responds best to a two-pronged attack combining gait-correction and physiotherapy.  We spoke to Andrew Stanley from the Rebound Clinic, a registered podiatrist and expert in biomechanical injuries, and Dean Payne of Optimum Physiotherapy and Sports Conditioning, a chartered physiotherapist and exercise biomechanic.

Andrew says:
 
“The plantar fascia is a soft tissue structure inside the bottom of the foot which helps stabilize and maintain the arch when walking. Your foot can work in a way that puts excess force on this tissue, causing strain, inflammation and heel pain known as plantar fasciitis.
 
“It can be a short-term problem caused by incorrect footwear or terrain that slopes in a way which forces down the arch, like contouring round a hill. More commonly, it’s the foot function itself, with the arch dropping excessively while walking.
 
“Typically, if you have a problematic gait, plantar fasciitis begins as an intermittent, irritating heel pain. It then progresses over weeks/months to a more constant painful condition that can eventually become debilitating.
 
“A classic symptom is acute pain first thing in the morning when rising from bed, or after standing or sitting down for a while. This initial acute pain recedes after several steps to a constant ache in the heel that lasts the rest of the day.
 
“If plantar fasciitis is diagnosed early, it can be treated successfully with off the peg foot-supports (for a slight/moderate dysfunction), available from outdoors shops, supplemented with daily stretching/strengthening exercises.
 
“If the dysfunction is excessive a more accurate/professional treatment is required, and custom-made supports known as orthoses. These will correct problems, support the feet and reduce pressure on the plantar fascia.
 
“Ensure the podiatrist you consult is trained to degree level and specializes in biomechanics – check the Rebound Clinic for info on what qualifications and facilities to look for, and how much you should expect to pay.”
 
Dean says:

“Both exercises and stretching can help strengthen the plantar fasciia. Tight calf muscles can be a contributing factor, so stretch them three or four times a day for 20-30 seconds a time.

"You can either do this sitting down with your leg in front of you, using a towel across the bottom of your foot to pull it towards you until you feel a stretch. Do this with knee bent and then straight to work the whole calf. Alternatively, stand up with one leg in front of the other and push the heel of the rear foot into the ground. Widen the stance until you feel the calf stretch, and do this with the rear leg straight and then bent.
 
“To strengthen the feet, place them flat on the floor then push your toes into the floor by contracting the muscles under your foot. Also try spreading a towel on the floor, putting your feet flat on it and using your toes in a clawing action to scrunch the towel up towards you. Alternatively, try picking up and dropping marbles with your toes. Aim for 12 repetitions on each foot, three times a day (unless there is a negative response, in which case stop and consult a physiotherapist).

“And if you’re sore after a long walk, rolling a frozen plastic bottle of water under the sole of your foot can provide short-term relief."