By: Lauren Hogan, PT, DPT, OCS, ATC
Plantar fasciitis is one of the most common foot-related conditions that we see in the clinic. Around 10% of people will experience plantar fasciitis at some point in their lives. It can be incredibly painful to put weight on the foot and walk, making it a very challenging injury for patients to deal with.
What is Plantar Fasciitis?
The plantar fascia (or aponeurosis, as labeled in the picture above) is a thick band of connective tissue that attaches from the heel bone up through the toes. As we walk, the plantar fascia works to help support the arch, along with muscles in the foot and ankle. When we sleep or sit, our feet are often in a pointed toe, relaxed position, so the plantar fascia may be resting in a shortened for a prolonged period of time. When we get up in the morning or stand after sitting for a while, the plantar fascia is suddenly stretched as we put weight on the foot. For people that have irritation of the plantar fascia, the attachment at the heel can be painful for several steps until the tissue starts to loosen up.
Anyone can get plantar fasciitis, but there are several factors that can put someone at risk for developing pain through their heel. Tightness through the calf and limited ankle range of motion are common causes. Runners and workers that spend a lot of time on their feet on hard surfaces are more likely to be diagnosed with the condition. Patients with a higher body mass index also may be at increased risk. Poor footwear can also be a triggering factor.
There are several things you can start doing if you are experiencing heel pain.
- Wear supportive shoes consistently throughout the day. Adequate arch support and cushioning are necessary to help avoid irritating the plantar fascia.
- Stretching the calf muscles is extremely important. The more mobile the calf muscles and ankle are, the less strain there is through the plantar fascia with walking.
- Rolling through the bottom of your foot with a golf ball can help massage the arch and surrounding muscles.
- Icing or rolling the foot over a frozen water bottle can help relieve pain.
- Sitting with your feet flat on the ground helps to maintain a little bit of a stretch through the calf and foot, making it less painful when you first get up and start walking.
If your symptoms are not improving within a few days with self-treatment, a physical therapist can help. Treatment may consist of hands-on massage to loosen up tissues in the calf and foot, joint mobilization to improve foot and ankle mobility, as well as work on strengthening the foot and ankle muscles, balance, and working on gait. Some patients may benefit from an orthotic insert to further support the foot, or a night splint to help gently stretch the calf at night to minimize pain first thing in the morning. You can ask your PT how to use these tools to help with your recovery.
Early treatment is important, as chronic plantar fasciitis can be challenging to treat and take longer to resolve. If you are in pain for more than a few days and it is not responding to the ideas above, talk to your physical therapist to get on the road to feeling better.