Risk factors are well established and include prolonged standing, higher body weight, reduced ankle dorsiflexion, excessive foot pronation, and increased or repetitive loading such as running. It affects both active individuals and those with more sedentary occupations that involve long periods on their feet.
Diagnosis is primarily clinical, but ultrasound imaging is a reliable and evidence-based tool used to confirm the diagnosis and identify pathology such as plantar fascia thickening, microtears, and changes in tissue structure. It also helps guide treatment decisions.
Clinical guidelines recommend exercise-based rehabilitation as first-line treatment, particularly plantar fascia–specific stretching and calf strengthening, which have strong evidence for reducing pain and improving function. Additional supported treatments include manual therapy to address joint and soft tissue restrictions, foot orthoses to offload the fascia, taping, and short-term use of splints where appropriate.
For persistent cases, adjunctive treatments may be considered. Extracorporeal shockwave therapy has moderate to strong evidence for improving pain and function in chronic plantar fasciitis. Corticosteroid injections can provide short-term pain relief, while other injection therapies may be used selectively.
Management is most effective when individualised, combining load management, rehabilitation, and targeted interventions to address both symptoms and underlying biomechanical factors.