Plantar fasciitis is a common problem that occurs in runners. It is an overuse injury of the plantar fascia, which is a strong ligament that runs across the bottom of the foot and has the role of holding up the arch of the foot. Plantar fasciitis is not really an “-it is” which means inflammation, it is more of a degeneration. The real cause of plantar fasciitis is that too much load is going through the plantar fascia for the tissue to adapt to. The most common risk factors for plantar fasciitis are anything that increases that load. This includes obesity (though not really a problem for runners), tight calf muscles, poor foot biomechanics and overuse.

The classic symptom of plantar fasciitis is pain at the center bottom of the heel, which is generally worse an arising from bed in the morning or other rest periods.

As plantar fasciitis is due to excessive load in the plantar fascia, then treatment as to reduce that load. This can be achieved by:
1. Weight loss (though this is not really a running issue and is a long term issue)
2. Activity modification – a reduction in the amount of weightbearing activity and its substitution with, for example, swimming
3. Stretching of the calf muscles
4. Strapping
5. Foot orthotics are probably the best and immediate way (apart from strapping) to reduce the load.

All other treatments like acupuncture, shockwave, massage, etc are all aimed at helping the tissues heal and not aimed at reducing the load in the structure.

Will the orthotics need to be used long term for plantar fasciitis?
Yes, if the magnitude of force causing the problem is so high that the tissues cannot adapt to that load.
No, if the magnitude of the force causing the problem is not so high and the tissues can adapt.