What is plantar fasciitis?

Plantar fasciitis is inflammation of the thick tissue on the bottom of the foot. This tissue is called the plantar fascia. It connects the heel bone to the toes and creates the arch of the foot. Plantar fasciitis occurs when the thick band of tissue on the bottom of the foot is overstretched or overused. Frequent load on the fascia can cause micro-cracks which lead to inflammation and degeneration of the connective tissue in the fascia.  This is painful and can make walking difficult. It has been reported that plantar fasciitis occurs in two million Americans a year and 10% of the population over a lifetime.

What causes plantar fasciitis?

Excessive running, jumping, or other activities can easily place repetitive or excessive stress on tissue and lead to tears and inflammation, resulting in moderate to severe pain. A change in exercise or heavier training is a common cause.

• Risk factors for plantar fasciitis include:
• Foot arch problems (both flat feet and high arches)
• Obesity or sudden weight gain
• Long-distance running, especially running downhill or on uneven surfaces
• Sudden weight gain
• Tight Achilles tendon (the tendon connecting the calf muscles to the heel)
• Shoes with poor arch support or soft soles

Plantar fasciitis most often affects active men ages 40 - 70. It is one of the most common orthopedic complaints relating to the foot.

What are the symptoms?

The most common complaint is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn.
The pain is usually worse:

• In the morning when you take your first steps
• After standing or sitting for a while
• When climbing stairs
• After intense activity

The pain may develop slowly over time, or suddenly after intense activity.

How do you treat plantar fasciitis?

Common treatments include:

• Acetaminophen or ibuprofen to reduce pain and inflammation
• Heel stretching exercises
• Resting as much as possible for at least a week
• Ultrasound
• Iontophoresis
• Joint mobilization
• Apply ice to the painful area
• Use of night splints
• Wearing a boot cast
• Orthotic inserts for shoes
• Steroid shots or injections into the heel

In a few patients, nonsurgical treatment does not work. Surgery to release the tight tissue becomes necessary.  If pain persists or get worse, you should consult a physical therapist or physician immediately.

How do you prevent plantar fasciitis?

To prevent plantar fasciitis, there are several important things you can do to minimize the possibility of this injury. 

• Make sure your ankle, Achilles tendon, and calf muscles are flexible. Do exercises to stretch the Achilles tendon at the back of the heel. This is especially important before sports, but it is helpful for non-athletes as well. Ask your physical therapist about recommendations for a stretching routine.
• Take care of your feet. Wear shoes with good arch support and heel cushioning. If your work requires you to stand on hard surfaces, stand on a thick rubber mat to reduce stress on your feet.
• Stay at a healthy weight for your height.
• Establish good exercise habits. Increase your exercise levels gradually, and wear supportive shoes.
• If you run, alternate running with other sports that will not cause heel pain.
• Wear supportive shoes.

It has been reported that plantar fasciitis occurs in two million Americans a year and 10% of the population over a lifetime.  With some care and assistance from a health care professional, you should be able to prevent the injury or recover from plantar fasciitis and return to full mobility. 

For Further Information
Ron Artest: Day by Day with Plantar Fasciitis, SportsMD.com
Plantar fasciitis, Physiopedia
Plantar fasciitis prevention, WebMD.com