Plantar fasciitis

Do you have plantar fasciitis?

Plantar Fasciitis is a cause of pain under your heel. It usually goes in time with the correct self-management. Treatment may speed up recovery. Treatments include rest, good footwear, insoles (orthoses), painkillers and stretching exercises. A steroid injection or other treatments may be used in more severe cases.

Plantar Fasciitis means inflammation of your plantar fascia (although often there is no inflammation involved). Your plantar fascia is a strong band of tissue (like a ligament) that stretches from your heel to your toes. It supports the arch of your foot and also acts as a shock absorber in your foot.

What causes plantar fasciitis?

Repeated small injuries to the fascia (with or without inflammation) are thought to be the cause. The injury is usually near to where the plantar fascia attaches to your heel bone. You are more likely to injure your plantar fascia in certain situations. For example:

If you are on your feet for a lot of the time e.g. walking, standing, running.
If you have recently started exercising on a different surface.
If you have been wearing shoes with poor cushioning, with poor arch support.
If you are overweight – this will put extra strain on your heel if there is an overuse or stretching of your sole e.g. athletes who increase running intensity or distances.
If you have a tight Achilles tendon.

Top tips

Read our top tips for improving plantar fasciitis.

Wear sensible well-fitting shoes, e.g. trainers.
Pace your activities by alternating activity with rest.
Do not walk around without footwear or unsupportive footwear e.g flip flops.
Take the pain medication your GP has prescribed.
Try an ice pack on your heel for 10 minutes (wrap it in a damp towel to avoid an ice burn). Do not use ice on your foot if you have poor sensation over the area, an infected wound, Raynauds Syndrome, or Cryoglobulinaemia.

How much pain is too much pain?

Before exercising

Before exercising, rate your pain at the moment on a scale of 0 to 10, where 0 is no pain and 10 is the worst pain you can imagine.

A maximum pain level

A maximum pain level of 4/10 whilst exercising is fine as long as it eases within 45 minutes of the session and does not interfere with sleep or activities the next day.

If your pain increases

If your pain increases beyond this, simplify the exercise by reducing the range of movement or number of repetitions, or try an easier exercise.

Exercise programme

Your symptoms should have significantly improved if not resolved after this 12 week programme.

If your symptoms have not improved with these exercises, please contact the podiatry team from Cambridgeshire and Peterborough NHS Foundation Trust on 0330 726 0077 or download a self referral form.

Everyday exercises

Please complete exercises A,B and C everyday for 12 weeks alongside either Level 1, 2 or 3, which you will be guided through below.

A) Toe Curls

Standing or sitting with your foot on the floor
Curl your toes, pressing down into the floor
Hold 10 seconds
Repeat 10 times

B) Toe Extension Stretch

Sit on a chair, crossing the affected leg over the opposite knee
Using the opposite hand to the injured side, place fingers across the base of the toes on the bottom of the foot
Pull the toes back toward the shin until you feel a stretch in the arch of the foot
Hold approx. 30-60 secs
Repeat 5 times

C) Standing Heel Raises

Push up on your toes, and slowly lower back down
Repeat 10 times

Level 1

Please start on Level 1 and complete for two weeks.

On the edge of a step, stand on affected leg with towel rolled up under your toes.
Raise up onto toes as high as possible - taking 3 seconds to complete the movement.
Hold at the top for 2 seconds.
Then slowly lower your heel down as far as possible, taking 3 seconds to lower.
Complete 12 repetitions, three times in a row (36 heel raises in a row) every other day for two weeks.
Once complete please move to Level 2.
Continue to complete your everyday exercises.

Level 2

Please start Level 2 and complete for six weeks (you no longer need to complete Level 1 exercises).

Wearing a back pack, add enough weight (you can use anything, books/water bottles work well) so that you can only do 10 repetitions.
On the edge of a step, standing on affected leg with towel rolled up under your toes.
Raise up onto toes as high as possible, taking 3 seconds to complete the movement.
Hold at the top for 2 seconds.
Please complete every other day.
Once complete, please move to Level 3.
Continue to complete your everyday exercises.

Level 3

Please start Level 3 and continue for at least four weeks, even if your pain has resolved. (You no longer need to complete Level 2 exercises).

Add more weight to the backpack until you can only complete 8 repetitions.
On the edge of a step, standing on affected leg with towel rolled up under your toes.
Raise up onto toes as high as possible - taking 3 seconds to complete the movement.
Hold at the top for for 2 seconds.
Then slowly lower your heel down as far as possible taking 3 seconds to lower.

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Need more help?

Consider self referring using the link below:

If you have a new injury or problem, please look at the self help information in our advice pages. We will often complete the same exercises and share information in clinic appointments.

If you still need some more help you can self refer into our service. Please note that the NHS is currently experiencing longer than normal waits, for more information visit our waiting times page.

Refer yourself to physiotherapy