Plantar fascia Case

The case histories and outcomes presented here are for general information only and do not replace the advice of a health professional. You should always consult a health professional who can take your own particular circumstances into account and advise you on that basis.

History: A 40-year-old female presented with pain in her left heel. It had been sore for a long time, but in the last 6 months had really flared up. The pain was worse in the morning and when walking or standing for long periods of time. She enjoys walking for exercise but hadn’t been able to because of the pain. This was interfering with her weight loss goals.

Objective: On examination, pain was located to the medial-plantar heel (inside of the heel, towards the arch). The area was swollen and tender to palpate. The plantar fascia was tight to palpate.

Diagnosis: Plantar fasciitis. An ultrasound investigation was ordered which confirmed thickening of the plantar fascia with intrasubstance tearing.

Treatment: Repeated ultrasound therapy was performed and rigid strapping applied for a number of weeks. She was advised to wear supportive shoes as often as possible, and apply a heat/ice pack. Gentle calf stretches and massage for the plantar fascia was recommended on a daily basis. Custom orthotics was ordered to support the arch, whilst offloading the painful area. With each visit, she reported gradual improvement. A ultrasound guided cortisone injection was performed, and this provided further relief.

Outcome: Fortunately within a few months of treatment, she was symptom free and able to walk comfortably. Now (three years later) she remains pain free and active.