Plantar fasciitis
What is Plantar Fasciitis?
Plantar fasciitis is a common, painful foot condition. It is caused by swelling and irritation of the thick tissue on the bottom of the foot. This tissue is known as the plantar fascia. The plantar fascia connects the heel bone to the toes, creating the arch of the foot.
When you walk or run, your weight is distributed across your feet. Therefore, the stress placed on this tissue is tremendous.
Plantar fasciitis is a common, painful foot condition. It is caused by swelling and irritation of the thick tissue on the bottom of the foot. This tissue is known as the plantar fascia. The plantar fascia connects the heel bone to the toes, creating the arch of the foot.
When you walk or run, your weight is distributed across your feet. Therefore, the stress placed on this tissue is tremendous.
Common Causes
- Repetitive or prolonged activities that place strain on the plantar fascia. Examples include:
* Runners, dancers and gymnasts
* People who walk excessively especially up hills or over uneven surfaces
* People who spend a lot of time standing
- Sudden increase in activity (Starting a new fitness program, starting a learn to run program, etc)
- Either excessively high arches or very flat feet.
- Increased weight gain (either from obesity or pregnancy).
- Sudden change from supportive to unsupportive footwear (i.e. wearing sandals during the summer).
- Tight calf muscles
- Occasionally plantar fasciitis may develop suddenly. This usually occurs when a great force is placed on the plantar fascia. I.e. jumping forcefully or accelerating very quickly.
Signs and Symptoms
- Pain underneath the heel and along the inner sole of the foot.
- Pain that usually is most painful first thing in the morning or when trying to stand up after sitting/lying down for a prolonged period of time.
- Pain that increases with excessive standing, walking or running (In the initial stages pain may lessen once the plantar fascia warms up. For example the person may experience pain at the beginning of their run but as they warm up it goes away).
- Mild swelling, redness, and tenderness on the bottom of the heel are also common symptoms.
- In more severe cases patients may walk with a limp or be unable to put weight through the affected leg.
This is the most common point of pain and tenderness for individuals with plantar fasciitis.
Treatment
- Rest from all activities that place excessive strain on your plantar fascia; running and prolonged walking/standing. This is not a permanent solution but you need to rest to allow the damaged tissues to heal.
- Ice: Apply ice to the painful area for 5-10 minutes every 2 hours by rolling a frozen water bottle along the arch of your foot.
Footwear: If you are used to wearing supportive shoes (i.e. sneakers or shoes with a good arch support) and you have recently switched to a flat shoe (i.e. a sandal or shoe without an arch support) this may be the cause of your plantar fasciitis. Go back to wearing your supportive footwear and slowly make the transition in to your unsupportive footwear. This way you will gradually stress the plantar fascia giving it time to adapt to the less supportive footwear.
Arch supports: Try purchasing off the shelf arch supports to wear for 1-2 weeks until the pain resolves. This gives the plantar fascia a break and allows the damaged tissues to heal. Do not leave the inserts in permanently as this will weaken the arch of your foot!
Stretch: Perform daily stretches to reduce tension in the plantar fascia, Achilles tendon and calf muscles. Hold for 20 seconds, repeat 7 times, 3 times a day.
Arch supports: Try purchasing off the shelf arch supports to wear for 1-2 weeks until the pain resolves. This gives the plantar fascia a break and allows the damaged tissues to heal. Do not leave the inserts in permanently as this will weaken the arch of your foot!
Stretch: Perform daily stretches to reduce tension in the plantar fascia, Achilles tendon and calf muscles. Hold for 20 seconds, repeat 7 times, 3 times a day.
Eccentric Strengthening: Strengthen your plantar fascia by doing eccentric exercises (the active contraction of a muscle while it's lengthening). In this situation, performing the heel raise is the concentric exercise while lowering the heels back down is the eccentric exercise.
For plantar fasciitis in the right foot (as shown in the picture) do the following:
- Sand with the balls of your feet on the edge of a step.
- Perform a heel raise lifting the heels up as high as you can.
- Lift your uninjured (in this case left) foot up so that all the weight is on your injured (in this case right) foot.
- VERY slowly lower your right foot until your heel is as low as it can go.
- Repeat this 10 times. Do 3 sets. Perform this exercise daily. As you get stronger start trying to increase towards doing 3 sets of 20.
- You can add a back pack with weight in it (i.e. books) to make this exercise harder.
NOTE: If you have plantar fasciitis in BOTH feet, to start this exercise perform your heel raise but try to take some of your body weight through your arms by using 1-2 railings.
Night splints: You can purchase night splints to wear while sleeping. The splint will stretch the plantar fascia through the night. You may need to start by wearing the splint for only one hour the first night, 2 hours the second night and so on.