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The plantar fascia is a very strong ligament that extends from the heel to the toes and helps to balance various parts of the foot while walking. It also helps to maintain the plantar arch. It therefore takes a lot of stress during the walking cycle. Micro injuries and repetitive strain on the plantar fascia can cause inflammation, particularly at the insertion of the plantar fascia onto the heel bone, however sometimes it happens in the mid-part of the foot.
The most common symptom is pain. The pain is usually located in the region of the heel however sometimes it appears in the mid-part of the foot on the plantar surface. It is more pronounced first thing in the morning and is aggravated by prolonged standing and walking. Towards the end of the day it may be more severe.
Change of walking habits, gaining of weight, obesity, walking on hard surfaces and use of shoes with little or no support can trigger the symptoms.
A heel spur is an extra little bone that grows very close to surface where the plantar fascia meets the heel bone. Heel spurs are common in people with plantar fasciitis, however they can be found in people with no heel pain at all. It has been proved that the heel spur is probably part of the condition, however the spur alone is not itself the cause of the pain.
This is very rarely required for plantar fasciopathy (fasciitis). It should only be considered in patients who do not respond to physiotherapy and other non-operative treatment after 12 months. It is indicated in patients who have a very tight Achilles tendon. The traditional way of surgical treatment was to release part of the plantar fascia. However, recent research suggests that release of the medial head of the Gastrocenemius muscle (Achilles tendon) just below the knee cavity improves symptoms in 82% of patients.
Usually plantar fasciopathy (fasciitis) gets better eventually over time. However, when it happens once you are more likely to have it appear again. It is advisable to continue with stretching of the Achilles tendon regularly to avoid further episodes.
In most of the patients the pain settles with physiotherapy and stretching. However the treatment can take a long time, up to six months or a year. There is a small percentage of patients where the plantar fasciopathy (fasciitis) never gets better and the pain persists for many years.
Mr Charalambos Charalambides qualified as a medical doctor from the Aristotle University Medical School of Thessaloniki in Greece. Following completion of two Orthopaedic training programmes in Greece & England, he has gained a wide experience in all aspects of Orthopaedic Surgery.
His special interest is Foot and Ankle surgery, including trauma to the Ankle and Foot in adults. He performs lower limb arthroplasties and arthroscopies, and treats all aspects of trauma patients having complex fractures.
A private consultation with Mr Charalambides at Highgate Private Hospital costs £250 if you are self-funding your treatment. We accept all major health insurers, but please contact your insurance company prior to booking an appointment if you plan to use your private health insurance.
To book an appointment:
T: 0208 341 3422