How is Plantar Fasciitis Diagnosed?

Plantar fasciitis can often be identified from your symptoms and clinical examination. Imaging is not required for every patient, but it can be useful where symptoms are persistent, the diagnosis is uncertain, or an image-guided procedure is being considered.

Diagnostic Ultrasound Assessment

Where clinically appropriate, we can use musculoskeletal ultrasound to assess the plantar fascia and surrounding structures.

An ultrasound examination may assess:

• Plantar fascia thickness
  A thickened plantar fascia, particularly close to its attachment at the heel, can be associated with plantar fasciopathy.

• Fascial structure and echogenicity
  Ultrasound can identify changes in the normal fibrillar appearance of the plantar fascia, including hypoechoic or degenerative-looking areas.

• Focal tears or other abnormalities
  Imaging can help identify structural changes and assist with the differential diagnosis where symptoms are atypical.

• The heel and surrounding anatomy
  Associated findings can be documented and other potential causes of pain considered where appropriate.

Ultrasound measurement of plantar fascia thickness has demonstrated good reliability when performed appropriately, although imaging findings should always be interpreted alongside the patient's symptoms and clinical examination.

Our Plantar Fasciitis Treatment Pathway

Treatment is matched to the severity and duration of your symptoms, previous treatment and findings from your assessment.

Conservative plantar fasciitis treatment

For most patients, treatment starts by reducing excessive load on the painful plantar fascia while progressively improving its capacity to tolerate normal activity.

Your treatment program may include:

• Plantar fascia and calf stretching

Specific plantar fascia and calf stretching can help reduce pain and improve mobility.

Rather than simply telling you to "stretch your foot", we develop a program suited to your symptoms, flexibility, activity and stage of recovery.

Plantar fascia-specific stretching forms part of recommended conservative management for plantar heel pain.

• Load and activity modification

Completely stopping activity is not always necessary.

Instead, we assess activities that may be repeatedly aggravating the plantar fascia — such as running volume, prolonged standing, walking distance or changes in training — and help you modify these while your symptoms settle.

The aim is to find a manageable level of activity before progressively rebuilding capacity.

• Strapping and taping

Foot taping can provide short-term support and may reduce plantar heel pain while other components of treatment are introduced.

Taping is particularly useful when we want to determine whether changing load through the foot improves your symptoms before considering longer-term options.

• Orthotic therapy

Foot orthoses may be recommended when additional support or redistribution of load is appropriate.

This may involve an off-the-shelf device or customised orthotic depending on your foot, footwear, occupation, activity and clinical findings.

Orthoses are generally used as part of a broader treatment program, rather than as the only treatment for plantar fasciitis.

• Footwear modification

Shoes can substantially change the forces placed through the heel and plantar fascia.

We can assess your current footwear and recommend changes in cushioning, support, fit or shoe type where appropriate.

Supportive footwear and arch supports are also included among commonly recommended measures for plantar fasciitis.

• Night splints

If your main symptom is severe pain with your first steps in the morning, a night splint may be considered.

Night splints hold the foot in a position designed to reduce prolonged shortening of the plantar fascia and calf complex overnight.

Clinical guidelines recommend a 1–3 month night-splint program for people with plantar fasciitis who consistently experience first-step morning pain.

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