Plantar Fascitis

The plantar fascia is a thick strap of tendon-like tissue that runs on the bottom of your foot that supports the arch. The fascia runs from the heel bone out to the ball and is pulled taut like the head of a drum. Plantar fascitis is a painful inflammation of this fascia due to the tension on the fascia, or due to tiny spurs that grow on the fascia at the point where it attaches to the heel.

How does plantar fascitis occur?
Plantar fascitis occurs from plantar fascia that is pulled too tightly or has been irritated by overuse. When high-heeled shoes are worn, the angle of the foot eases the tension on the plantar fascia such that it does not stretch as far as usual over the bottom of the foot. The foot becomes accustomed to this and the plantar fascia may actually shorten in length. Wearing flat shoes or going barefoot after this will stretch the fascia back out, putting uncomfortable tension and on the bottom of the foot.

Pressure and stress on the plantar fascia and surrounding tissues may occur due to a rapid increase in running, walking, or climbing stairs. Standing for long periods of time during the day, particularly on hard floors, can also put excessive stress on these tissues.

Plantar fascitis pain may also occur after a weight gain. The increased pressure of the body weight can push down through the body's cushioning pads under the heel bone and put pressure on the plantar fascia. Other factors that may play a part in the onset of plantar fascitis may be loss of elasticity in fascia due to age, wearing poorly cushioned shoes, over-pronation, and weak or inflexible calf and foot muscles.

What are the signs and symptoms of plantar fascitis?
Plantar fascitis is usually felt as pain in the heel during walking, which can worsen to pain when standing or sitting. Plantar fascitis is especially painful after long periods of rest, such as in the morning when feet are first placed onto the floor. This occurs due to stretching out the shortened, tightened plantar fascia. Walking around through the day "stretches" the plantar fascia out a bit, which may make it less painful.

How is plantar fascitis diagnosed?
To diagnose plantar fascitis, your doctor will examine your foot and ask you some questions about the history of your foot pain. Your doctor may have an x-ray taken of your foot to look for other problems such as broken bones that may be causing your pain.

How is plantar fascitis treated?
Your doctor will probably recommend that you restrict the activities that likely caused the plantar fascitis pain, which may include being on your feet for long periods of time over the day, running, or wearing high-heeled shoes. You may also try stretching exercises, well-cushioned shoes, ice packs on the heel, and maintaining a healthy weight to decrease the stress on the plantar fascia and related tissues. Your doctor may prescribe non-steroidal anti-inflammatory medications (such as ibuprofen) to help reduce pain and inflammation.

Severe cases of plantar fascitis may need physical therapy, which can help stretch the tissues and strengthen the muscles surrounding the ankle and heel for better stability.

When can I expect to recover from plantar fascitis?
Recovery time for plantar fascitis varies, depending on the severity of the condition. During recovery, close attention to the treatment recommended by your doctor and limitation of activities that may contribute to the pain and irritation will speed your healing process. It may take only a few weeks or up to six months for a full recovery.