Health Center :: Plantar Fasciitis

The plantar fascia is the flat band of ligament that connects your heel bone to your toes. Its job is to provide arch support and shock absorption. Plantar fasciitis is an injury affecting the sole or flexor surface of the foot. While the injury itself affects the plantar fascia (fibrous band), it is often described by sufferers as “heel pain”.  

How do you know if you have plantar fasciitis?

• Do the first few steps in the morning cause incredible pain in your heel?
• Do you have heel pain after jogging or other weight-bearing activities?
• As you walk more during the day, does the pain lessen?
  
  Then you may have plantar fasciitis.

Plantar fasciitis usually develops gradually, but it may feel as though it has happened suddenly and the pain can be quite severe.  Symptoms include:

• Sharp, stabbing pain in the inside part of the bottom of your heel
• Heel pain that tends to be worse with the first few steps after awakening, after getting up from a seated position, after standing for a long period of time, when climbing stairs and/or when standing on tiptoe
• Heel pain that begins after, but not typically during, exercise

While you can treat plantar fasciitis on your own, a doctor or a podiatrist will most effectively diagnose your condition.

How does plantar fasciitis occur?

In a normal step, the plantar fascia ligament stretches as the foot hits the ground but abnormal steps or repetitive pressure on the heel can cause the ligament to stretch irregularly leading to serious pain. The pain can be dull, aching or sharp and can usually be reproduced by flexing the toes upwards. 

While abnormal steps are one cause, inadequate calf muscle and Achilles tendon flexibility, lack of arch support, being overweight, suddenly increasing activity, and spending too much time on your feet are other common causes. 

Your risk of developing plantar fasciitis increases with many factors, including:

Activity:  If you participate in weigh-bearing activities, such as running, dancing, tennis or aerobics that rely heavily on your foot for arch support and your heel for shock absorption,you are at a higher risk for plantar fasciitis.

Age:  As you age, the arch of your foot begins to sag, putting stress on the plantar fascia. This stress can often lead to plantar fasciitis.

Weight:  Extra weight can break down the fatty tissue under the heel bone decreasing shock absorption and increasing the potential for heel pain and plantar fasciitis.

Pregnancy:  Pregnancy can be hard on the body – including the feet.  The weight gain and swelling that accompany pregnancy can cause ligaments in your body to relax. The resulting inflammatory
conditions increase the potential for heel pain and plantar fasciitis.

Occupation:  If your occupation requires a lot of walking or standing on hard surfaces (i.e. - teaching, waiting tables, or working in a retail store) you are placing extra stress on your feet every day.  This extra stress, without preventative measures, can lead to plantar fasciitis.

Sandal or heel wearers:  The sacrifices you make for fashion can be far greater than you realize.  Loafers, sandals, boots and pumps without arch support and heel cushioning can mean a lot more than a little pain while you wear them.  This lack of support can cause a long-term break down of the plantar fascia.

If you don't treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity and the “domino effect” may be significant.  Your heel pain can quickly become knee, hip or back problems due to the change in the way that you walk to avoid your heel pain. 

In most cases, you can overcome the pain of plantar fasciitis with steps you take at home to treat it and prevent recurrence.

How can plantar fasciitis be prevented or treated?

The symptoms of plantar fasciitis are typically resolved more quickly when treatment is started at the first sign of pain. If you have heel pain, you can try self-care options right away. If you don't see much progress after a few weeks of home treatment, see your doctor or a podiatrist. 

If your pain worsens seek the diagnosis of a professional sooner. And if you have diabetes or another condition that causes poor circulation, talk with your doctor about any changes in your feet.

In many cases the treatment for plantar fasciitis is much the same as the preventative measures. Whether you currently have plantar fasciitis or you are looking to prevent a recurrence, the following are some simple steps you can take: 

Support your feet:  Your choice of shoes and the added support you can give them can make all the difference.

• Choose supportive shoes.  This isn’t the first time you’ve read that high heels and even flat shoes can be bad for your feet.  So, if you want to stop the pain or want to take steps to prevent plantar fasciitis, buy shoes with a low to moderate heel, good arch support and shock absorbency.  And try not to go barefoot, especially on hard surfaces.
• Replace your insoles: High-impact activity is already a contributor to plantar fasciitis, so be sure that your athletic shoes are providing the maximum support.  Replace your insoles before they stop supporting and cushioning your feet.  The same goes for dress shoes. Designers are typically focused on the outside of the shoe – so you need to focus on the inside.  It’s a good idea to replace the insole of even a new pair of shoes with one that provides more support, especially arch support, and shock absorption.

Stretch:  You can reduce pain and help prevent future episodes of inflammation by stretching your calves, plantar fascia, arches and Achilles tendon on a regular basis and warming up before starting any physical activity.  Some exercises include:

• Stretch into your day:Before you get out of bed in the morning, stretch your calf muscles, arch and Achilles tendon by reaching for your toes and gently flexing your foot. This helps loosen the plantar fascia that tightens overnight.
• Stretch your arches:  Simple exercises can stretch or strengthen your plantar fascia, Achilles tendon and calf muscles. Rolling the foot over a tennis ball is one that’s easy and effective.  Additionally, there are physical therapist recommended stretching devices that can provide deep stretches that help with long-term prevention.

Be healthy:  Maintaining a healthy weight minimizes the stress on your plantar fascia.

All of the options above are helpful for both the treatment of plantar fasciitis.  Options exclusive to treatment include:  short-term use of anti-inflammatory drugs (available without a prescription at your local drug store), ice, and heat. 

If self-care techniques don't help, your doctor might suggest other treatments to heal your heel which could include night splints, custom orthotics, physical therapy, corticosteroids or in extreme cases, surgery.  Talk with your doctor about what’s right for you.

Plantar fasciitis suffers have found these products
helpful in controlling pain and preventing inflammation: