Understanding chronic heel pain and plantar fasciitis

Understanding chronic heel pain and plantar fasciitis 854 471 BeckmanDev



Did you know, in our lifetime, the average person walks approximately 160,000 kilometres? But all too often, we do not place the same emphasis on looking after our feet as we do on other parts of our body.

Overuse injuries of the foot may lead to plantar fasciitis, which is one of the most common causes of heel pain. Plantar fasciitis involves inflammation of the plantar fascia.


Fasciitis is the most common injury of the plantar fascia and is estimated to induce more than 1 million patients to seek treatment every year. The plantar fascia is a thick, ligamentous structure that runs from the bottom of the heel, across the foot to the toes.


The fascia is the largest ligament in the human body, designed in the shape of a bowstring which supports the footbridge, absorbing the shock when walking. The fascia consists of 3 bundles, central, lateral and medial.


The central component is proximally thick and distally thin and is the thickest of the three. These large fibrous bundles are embedded within a matrix of loose connective tissue containing type III collagen and a few elastic fibres.


Plantar fasciitis can develop without obvious causes; however, some factors may increase your risk of developing plantar fasciitis.


Risk factors include:

> Most common between the ages of 40-60 years.

> Certain types of exercise. Plantar fasciitis is common in runners, however, activities resulting in stress on the heel, for example, ballet dancing may contribute to the onset of plantar fasciitis.

> Foot mechanics. People with foot deformities (flat feet, high arch, abnormal walking pattern) are also at risk of developing plantar fasciitis. Some underlying medical conditions such as spondyloarthropathies and rheumatoid arthritis are also associated with plantar fasciitis.

> Extra weight puts extra stress on the plantar fascia.

> People who spend most of their work hours walking or standing on hard surfaces for example factory worker’s or teachers are more at risk of developing plantar fasciitis.

> Bony growths or spurring at the bottom part of the heel (calcaneal enthesophytes), is likely a possible cause.


Successful outcome rests on the adequate diagnosis and focused treatment for the best possible recovery, so if you suspect plantar fasciitis or would like to know more about diagnosis and imaging of plantar fasciitis, reach out to Keystone Radiology at 087 055 0587 or