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What Is Plantar Fasciitis?

Plantar fasciitis is a load-related condition affecting the plantar fascia — a thick band of connective tissue under the foot that supports the arch.

Despite the name, it is not primarily inflammatory.

Modern research classifies it as a degenerative load-related condition, similar to other tendinopathies.

It develops when repetitive load exceeds the fascia’s capacity to adapt.

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Symptoms of Plantar Fasciitis

You may have plantar fasciitis if you experience:

• Sharp heel pain with the first steps in the morning

• Pain after prolonged sitting

• Pain at the inside heel

• Pain during or after running

• Tenderness at the base of the heel

• Stiffness that improves after moving

Morning pain is one of the most characteristic features.

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What Causes Plantar Fasciitis?

Modern guidelines emphasise that plantar heel pain is usually due to load–capacity mismatch.

Common contributing factors include:

1. Sudden Increase in Activity

• Rapid mileage increase

• Increased walking

• New gym program

• Return to running after time off

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2. Reduced Foot & Calf Strength

Strong evidence supports the role of:

• Calf muscle weakness

• Reduced intrinsic foot muscle strength

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3. Load & Footwear Changes

• Sudden shoe changes

• Increased time barefoot

• Increased hill exposure

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Do I Need a Scan?

Usually no.

Ultrasound or MRI may show:

• Thickened plantar fascia

• Degenerative changes

However, imaging findings do not always correlate with pain severity.

Diagnosis is primarily clinical.

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Evidence-Based Treatment for Plantar Fasciitis

Current clinical practice guidelines strongly recommend:

1. Progressive Strengthening (Primary Treatment)

Strength-based rehabilitation improves long-term outcomes.

Programs typically include:

• Heavy slow calf raises

• Intrinsic foot strengthening

• Single-leg loading

• Progressive impact reintroduction (for runners)

Strengthening the calf–plantar fascia complex improves load tolerance.

2. Load Management

We adjust:

• Running volume

• Walking load

• Hill exposure

• Plyometric activity

Complete rest is rarely necessary.

A pain-monitoring model guides progression.

3. Taping (Short-Term Relief)

Low-Dye taping may reduce symptoms short-term, particularly during flare-ups.

It is an adjunct — not a long-term solution.

4. Footwear & Orthoses

Temporary arch support or orthoses may reduce load and improve comfort.

However, strengthening remains essential for long-term recovery.

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⚠️ What Is Not Strongly Supported by Evidence

• Stretching alone

• Passive massage alone

• Repeated cortisone injections

• Complete immobilisation

Active rehabilitation produces better long-term outcomes.

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Can I Keep Running With Plantar Fasciitis?

Often yes — depending on severity.

If:

• Pain is manageable

• Symptoms settle within 24 hours

• Load is modified appropriately

Running can often continue in structured form.

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How Long Does Plantar Fasciitis Take to Improve?

Recovery depends on:

• Duration of symptoms

• Load management

• Strength progression

Typical timelines:

• Early improvement: 4–6 weeks

• Significant improvement: 8–12 weeks

• Full resolution: 3–6 months

Long-standing cases may require longer rehabilitation.

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Why Plantar Fasciitis Becomes Persistent

Persistent symptoms are associated with:

• Underloading the fascia

• Repeated flare-ups

• Inadequate strength progression

• Poor footwear management

• Fear of loading

Structured progression reduces chronicity risk.

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Plantar Fasciitis in Runners

For runners, rehab includes:

• Running load modification

• Cadence adjustment if needed

• Calf capacity rebuilding

• Gradual reintroduction of hills

• Plyometric progression

At Omnia Physio, we integrate foot strengthening into full kinetic chain rehabilitation.

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Frequently Asked Questions

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Is plantar fasciitis inflammation?

Not primarily. It is usually a degenerative load-related condition.

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Should I stretch my plantar fascia?

Stretching may help short-term, but strengthening is more important long-term.

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Do I need orthotics?

Sometimes temporarily — but strength restoration remains essential.

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Is surgery common?

Surgery is rare and reserved for persistent cases after prolonged conservative management.

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Book Plantar Fasciitis Physiotherapy

If you’re experiencing persistent heel pain:

Omnia Physio – Potts Point, Sydney
Specialising in runners and active adults.

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