Plantar fasciitis

In summary: plantar fasciitis has a good prognosis and the vast majority of cases improve without surgery. The key is finding your cause —we assess it with ultrasound and gait analysis the same day— and treating it, not just calming the pain.

The plantar fascia is a band of tissue that runs from the heel to the toes and supports the arch of the foot. When overloaded, it becomes inflamed and causes pain —especially when taking the first steps in the morning. It is one of the most common causes of heel pain and, when properly treated, it evolves well in the vast majority of cases.

Not all fasciitis cases are the same: behind the same pain there can be a gait that loads incorrectly, shortening of the calf muscle, or overload from sport. Therefore, before treating, we look for your cause.

Plantar fasciitis in runners and in those who work standing up

Plantar fasciitis has two very clear profiles in the consultation. The runner who has increased kilometers or changed running shoes too quickly. And the person who spends many hours standing on hard surfaces, often with flat footwear.

In both cases the mechanism is similar: the fascia receives more load than it can assume and becomes irritated. The difference lies in how we approach it.

In runners, it is not enough to calm the pain: it is necessary to review running gait, footwear, and training progression. This is the realm of sports podiatry, where the objective is not only for it to stop hurting, but for you to be able to keep running without relapsing.

If your case is standing work, the key is usually to better distribute the load: appropriate footwear and, when gait contributes, custom insoles designed based on your 3D scan study.

Exercises for plantar fasciitis: what you can do at home

There are exercises that usually help, provided the diagnosis is clear:

• Gentle stretches of the calf and the sole of the foot, without reaching pain.
• Rolling a small ball or a bottle under the sole, with moderate pressure.
• Strengthening the foot muscles, for example by scrunching a towel with your toes.

However, an important nuance: if what you have is not fasciitis, these exercises may be of no use —or may even bother you more. Before following videos for weeks, it is worth confirming the diagnosis. We do this with ultrasound at the first visit, in the same consultation.

How long does it take for plantar fasciitis to improve

It is the question everyone asks, and the honest answer is: it depends. It depends on how long you have had it, the specific cause, your daily activity, and how your tissue responds.

What we can tell you is what we see every week: fasciitis cases that are treated early and addressing the cause usually evolve better than those that have been “endured” for months. And when the initial treatment is not enough, there are next steps —from regenerative treatments to ultrasound-guided injections— before considering anything else.

If your heel has been bothering you for a long time, you might also be interested in understanding the real role of the heel spur: it often appears on X-rays, but it is rarely the true culprit of the pain.