Plantar fasciitis is one of the most common causes of heel pain. It is an inflammation of a thick band of tissue that runs across the bottom of the foot and connects the heel bone to the toes (plantar fascia).
Plantar fasciitis is most commonly caused by:
- Sudden increases in mileage
- Poor foot structure
- Poor running shoes
This can overload the plantar fascia, the connective tissue that runs from the heel to the base of the toes. The plantar fascia may look like a series of fat rubber bands, but it’s made of collagen, a rigid protein that’s not very stretchy.
The stress of overuse, overpronation, or overused shoes can rip tiny tears in it, causing pain and inflammation, a.k.a. plantar fasciitis.
Plantar fasciitis symptoms
Plantar fasciitis sufferers feel a sharp stab or deep ache in the middle of the heel or along the arch. Another sign is the morning hobble from the foot trying to heal itself in a contracted position overnight. Taking that first step causes sudden strain on the bottom of the foot. The pain can recur after long spells of sitting, but it tends to fade during a run, once the area is warmed up.
Causes of plantar fasciitis
Plantar fasciitis tends to strike those who overtrain, neglect to stretch their calf muscles or overdo hill work and speedwork.
Plantar fasciitis can also be caused by biomechanical flaws including:
- Flat feet
- High-arched feet
- Tight Achilles tendon
- Excessive pronation
- Sudden increases in training mileage
- Beginning speedwork
- Wearing old running shoes
- Running on hard surfaces, like asphalt or concrete
- Wearing high heels all day before switching into flat running shoes
Plantar fasciitis is diagnosed based on your medical history and physical examination. During the exam, your doctor will check for areas of tenderness in your foot. The location of your pain can help determine its cause.
Usually no tests are necessary. Your doctor might suggest an X-ray or magnetic resonance imaging (MRI) to make sure another problem, such as a stress fracture, is not causing you pain.
Sometimes an X-ray shows a piece of bone sticking out (spur) from the heel bone. In the past, these bone spurs were often blamed for heel pain and removed surgically. But many people who have bone spurs on their heels have no heel pain.
Treatment of plantar fasciitis
At the first sign of soreness, start doing the following:
- Massage (roll a golf ball under your foot)
- Apply ice (roll a frozen bottle of water under your foot)
What you wear on your feet when you’re not running makes a difference. Arch support is key, and walking around barefoot or in flimsy shoes can delay recovery.
More plantar fasciitis treatment
If pain is present for more than three weeks, see a sports podiatrist.
Treatments such as:
- Foot taping
- Cortisone injections
- Night splints
Anti-inflammatories decrease symptoms significantly in about 95 percent of sufferers within six weeks. For more stubborn cases, physical therapy may be prescribed; six months of chronic pain may benefit from shock-wave therapy, an FDA-approved plantar-fasciitis treatment.
While it’s typical to experience pain in just one foot, massage and stretch both feet. Do it first thing in the morning, and three times during the day.
Prevention of plantar fasciitis
Plantar fasciitis can be a nagging problem, which gets worse and more difficult to treat the longer its present.
To prevent plantar fasciitis, try this:
- Run on soft surfaces
- Keep mileage increases to less than 10 percent per week
- Get the proper shoes for your foot type and gait
- Stretch the plantar fascia and Achilles tendon
Plantar fascia stretches
- Achilles Tendon Stretch: Stand with your affected foot behind your healthy one. Point the toes of the back foot toward the heel of the front foot, and lean into a wall. Bend the front knee and keep the back knee straight, heel firmly planted on the floor. Hold for a count of 10.
- Plantar Fascia Stretch: Sit down, and place the affected foot across your knee. Using the hand on your affected side, pull your toes back toward your shin until you feel a stretch in your arch. Run your thumb along your foot–you should feel tension. Hold for a count of 10.