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OVERVIEW

What is the plantar fascia?

Plantar fasciitis is an inflammatory condition. It occurs in the plantar fascia, which is a band of tissue that runs along the bottom of your foot. It forms the arch of your foot and connects your heel to your toes. If the band is short, you’ll have a high arch, and if it’s long, you’ll have a low, or flat arch. A pad of fat covers the tissue and helps absorb the shock put on your feet. Damage to the plantar fascia can be a cause of heel swelling and pain.

CAUSES & RISK FACTORS

Pain and swelling are the main symptoms of plantar fasciitis. Pain may be worse in the morning or when you put pressure on your heel. It may be dull or sharp, depending on the time of day and what you’re doing.

What causes the heel pain?

As you age, the plantar fascia becomes less like a rubber band and more like a rope that doesn’t stretch as well. The fat pad on your heel becomes thinner and can’t absorb as much shock. The extra shock can damage the plantar fascia and may cause it to swell, tear or bruise.  Most people also have pain to some degree.

Repeated impact on the heel, like from running, walking, or standing, also can cause plantar fasciitis. Existing foot arch problems – such as flat feet and high arches – can also cause plantar fasciitis.

DIAGNOSIS & TESTS

How is plantar fasciitis diagnosed?

Your healthcare provider will examine your foot and review your symptoms. They will want to know about your pain, when it occurs, and how long you’ve had it. Your healthcare provider may order tests to make sure the pain is not caused by another problem. These tests could include an X-ray or magnetic resonance imaging (MRI).

PREVENTION

Can plantar fasciitis be prevented or avoided?

You cannot prevent plantar fasciitis if aging is the cause. However, there are risk factors that can increase your chance of getting it. You may be able to avoid one or more of these. Risks include:

• Being overweight or having obesity
• Having diabetes
• Spending most of the day on your feet
• Doing repeated movements that put more impact on your feet and heels
• Becoming very active in a short period of time
• Having very high arches
• Having tight calf muscles

TREATMENT

In most cases, your doctor will start with basic treatments that can be done at home. These may vary depending on the cause of your pain.

• If you walk or run a lot, you may need to cut back.
• If you have high arches, ask your healthcare provider about using shoe inserts called orthotics. These help to support your arches. You will need to be fitted for them.
• If you are overweight or have obesity, losing weight can help reduce pressure on your heels.
• If your job involves standing for long periods of time, place some type of padding on the floor where you stand.  You also may try orthotics to provide extra cushion to your heels.
• You also should treat with ice to decrease inflammation. Put your foot on ice for about 10 minutes 2-3 times per day.

Stretching exercises for your foot are important. Do the stretches shown here at least twice a day. Don’t bounce when you stretch.

• Plantar fascia stretch: Stand straight with your hands forward against a wall. Place your injured leg slightly behind your other leg. With your heels flat on the floor and your feet pointed straight ahead, slowly bend both knees. You should feel the stretch in the lower part of your leg. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times.
• Calf stretch: Stand straight with your hands forward against a wall. Place your injured leg behind your other leg. With your injured leg straight, your heel flat on the floor, and your feet pointed straight ahead, lean forward slowly and bend the front leg. You should feel the stretch in the middle of your calf. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times.

Strengthening exercises are important as well. You can strengthen your leg muscles by standing on the ball of your foot at the edge of a step and rising up onto your toes as high as possible. Relax between toe raises and let your heel fall a little lower than the edge of the step. You can strengthen your foot muscles by grabbing a towel with your toes as if you are going to pick it up with your foot. Repeat these exercises several times a day.

Medicines, such as naproxen and ibuprofen, can help reduce swelling and pain.  Talk to your health care provider before you take any medicine.

Living with plantar fasciitis

Most cases of plantar fasciitis go away over time. For best results, try to be consistent in your treatment approaches. If these do not work, your healthcare provider may suggest other options, such as:

• Professional physical therapy
• Splints on your foot at night
• Tape on your foot
• Corticosteroid injections into the plantar fascia

In rare cases, you may need surgery. Talk to your healthcare provider about the benefits and risks of these treatments.