The plantar fascia is a flat band of tissue (ligament) that connects your heel bone to your toes. Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. Too much pressure on your feet over time can cause tiny tears in the ligament. The plantar fascia becomes inflamed with repetitive strain causing heel pain and stiffness, often experienced as a stabbing pain or aching in the bottom of your foot near the heel. This is known as plantar fasciitis (PLAN-ter fash-ee-EYE-tus), one of the most common causes of heel pain.
Most people with plantar fasciitis experience foot pain when they take their first steps after getting out of bed or sitting for a long time. You may have less stiffness and pain after you take a few steps, but your foot or feet may hurt more as the day goes on. It may hurt the most when you climb stairs or after standing for a long time.
Factors that may increase your risk of developing plantar fasciitis include:
Age. Plantar fasciitis is most common between the ages of 40 and 60.
Certain types of exercise. Activities which place a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and dance aerobics — can contribute to an earlier onset of plantar fasciitis.
Faulty foot mechanics. Being flat-footed, having a high arch or even having an abnormal pattern of walking can adversely affect the way weight is distributed when you’re standing and put added stress on the plantar fascia.
Obesity. Excess pounds put extra stress on your plantar fascia.
Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can damage their plantar fascia.
Pregnancy. Women who are pregnant often experience bouts of plantar fasciitis, particularly during late pregnancy.
Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities. If you change the way you walk to minimize plantar fasciitis pain, you might also develop foot, knee, hip or back problems.
What you can do at home
Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve) may ease the pain and inflammation associated with plantar fasciitis.
Give your feet a rest. Cut back on activities that make your foot or feet hurt. Try a low impact sport like swimming or bicycling.
Get a new pair of athletic shoes with good arch support and a cushioned sole.
Do toe stretches, calf stretches, and towel stretches several times a day, especially when you first get up in the morning. (For towel stretches, you pull on both ends of a rolled towel that you place under the ball of your foot.)
Apply ice. Hold a cloth-covered ice pack over the area of pain for 15 to 20 minutes three or four times a day or after activity.
Try ice massage. Freeze a water-filled paper cup and roll it over the site of discomfort for about five to seven minutes. Regular ice massage can help reduce pain and inflammation.
When to seek professional help
If your pain doesn’t decrease within a few weeks with home remedies, contact Paspa Physical Therapy for a consultation.
The therapists will perform a detailed evaluation and then implement a treatment program, which can include manual techniques, education, stretching and strengthening exercises.
Plantar fasciitis most often occurs because of injuries that have happened over time. While it may take time to recover completely, the right therapy for you will significantly speed recovery and help you to prevent re-injury.
- Best exercises and remedies for plantar fasciitis
- Untreated, plantar fasciitis can be serious | The Wichita Eagle
- Treatments for Burning Feet
- Foot Pain
- What is foot pain?
- What other symptoms might occur with foot pain?
- What causes foot pain?
- What are the potential complications of foot pain?
- Foot pain
- Plantar Fasciitis symptoms
- Why does it develop?
- How do I manage my Plantar Fasciitis?
- Plantar Fasciitis
- Plantar fasciitis treatment
- Causes and diagnosis
- Treatment options
- Don’t ignore it
- Plantar Fasciitis Treatment
Best exercises and remedies for plantar fasciitis
Plantar fasciitis may often be an overuse injury. Often, it occurs in runners or people who are overweight or obese. It may also cause tension in surrounding muscles, leading to pain beyond the heel.
A few simple stretches can reduce tension in the foot and calf. This offers both rapid pain relief and a steady improvement of symptoms over time.
People can perform these exercises two or three times every day. They should not be painful.
1. Stretching the calf
Muscle tightness in the feet and calves can make the pain of plantar fasciitis worse. Loosening the calf muscles can relieve the pain. Try the following stretch:
- lean your hands against a wall
- straighten the knee of the affected leg and bend the other knee in front
- keep both feet flat on the ground
- there should be a stretching sensation in the heel and calf of the extended leg
- hold for 10 seconds
- repeat two to three times
2. Rolling stretch
Placing a round object under the foot and rolling back and forth can help loosen up the foot muscles. People can use a rolling pin, golf ball, or specialized foam roller for this. Sports stores and online stores sell foam foot rollers.
Use the following steps to stretch the foot:
- sit tall on a chair
- roll a round object under the arch of the foot
- roll for 2 minutes
3. Stretching the plantar fascia
To relieve muscle tightness in the plantar fascia, try the following:
- sitting on a chair, cross the injured heel over the other leg
- hold the foot in your opposite hand
- pull the toes toward the shin to create tension in the arch of the foot
- place the other hand on the bottom of the foot to feel for tension in the plantar fascia
- use a towel to grasp and stretch the foot if it is difficult to hold otherwise
- hold for 10 seconds
- repeat two to three times
4. Foot flexes
Flexing the foot increases blood flow to the area and relieves tension in the calves, which can help with pain. This exercise uses an elastic stretch band, which people can buy from sports stores or online.
Use the following steps:
- sit on the floor with legs straight
- wrap the elastic band around your foot, holding the ends in your hands
- gently point the toes away from the body
- slowly return to starting position
- repeat 10 times
5. Towel curls
Curling a hand towel or facecloth with the toes can stretch the foot and calf muscles. Try doing these stretches before walking or doing any other morning tasks. Use the following steps:
- sit on a chair with both feet flat and a small towel in front of the feet
- grasp the center of the towel with your toes
- curl the towel towards you
- relax the foot and repeat five times
6. Marble pickups
Picking up a marble with the toes will flex and stretch the foot muscles. Use the following steps:
- sit on a chair with knees bent and feet flat on the floor
- place 20 marbles and a bowl at your feet
- pick up one marble at a time by curling your toes, and place the marble into the bowl
- repeat 20 times
Untreated, plantar fasciitis can be serious | The Wichita Eagle
As if the first steps out of bed in the morning aren’t torturous enough already, many people suffer stabbing pains in their feet as they limp their way to the bathroom.
That morning symptom is a hallmark of plantar fasciitis, a common source of heel pain, which in turn is the top persistent foot ailment and among the most debilitating, according to the American Podiatric Medical Association. A 2009 association survey found that 40 percent of Americans have suffered heel pain, and in 60 percent of those cases it has interfered with people’s daily activities.
The pain is easy to ignore at first, as it eases after you walk around a bit. But it’s unwise to leave it unchecked.
“It is so much harder to get rid of heel pain the longer you let it go,” said Marlene Reid, co-owner of Family Podiatry Center in Naperville, Ill., and president of the Illinois Podiatric Medical Association.
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Plantar fasciitis, an inflammation of the band of tissue that runs along the bottom of the foot from the heel bone to the toes, makes news when it sidelines professional athletes. Though engaging in strenuous sports is one way to tear and inflame the fascia, other causes abound, such as being overweight, having high arches or flat feet, standing or walking for long periods on hard surfaces such as cement, or wearing unsupportive shoes.
Open-heeled shoes such as flip-flops, slides or sandals are common culprits, as are new shoes your feet aren’t accustomed to and old shoes with worn-out heels, Reid said. This is one of the few conditions for which high heels are not the evildoers.
The pain, concentrated where the heel meets the arch of the foot, is worst in the morning because the ligaments tighten and fluid accumulates at the inflamed area while you sleep. It subsides after you walk around for a few minutes, but a dull ache usually returns later in the day, especially after you’ve been sitting or standing for a long time.
If left untreated, the symptoms can change, with the pain deepening and lasting beyond the morning. At that point, the condition morphs from acute inflammation to a chronic problem and from plantar fasciitis to plantar fasciosis, when scar tissue blocks the healing process.
It’s best to treat plantar fasciitis at the first signs of pain, and a trip to the podiatrist is advisable to rule out other causes.
“It could be other things: It could be a stress fracture, a broken bone, a tumor, compression of a nerve or tarsal tunnel syndrome,” said Neil Scheffler, president of the Baltimore Podiatry Group.
If it is plantar fasciitis, treatment options range from stretching to surgery. Reid said she always starts patients out with the most basic treatment: exercises to stretch out the Achilles tendon, which also stretches the plantar fascia; anti-inflammatory medications; and wearing shoes with a stiff heel. Inserting a heel cup into your shoes also helps.
While their heels are healing, patients shouldn’t do any sports and should avoid sleeping on their stomach because it can cause the Achilles tendon to become tighter, Reid said. Scheffler said he advises his patients not to go barefoot at all, and to put running shoes on even to walk to the bathroom in the morning.
If that doesn’t help, patients might wear a night splint to gently stretch their calf and Achilles tendon while they sleep, or custom orthotics to correct any biomechanical problems. Physical therapy also helps to get more blood to the tissue to promote healing.
About 95 percent of patients will mend using those methods. But for people whose symptoms have progressed to chronic plantar fasciosis, it’s sometimes necessary to pursue more aggressive treatment.
Jennifer Maher had to resort to extreme measures when she was hobbled by heel pain as she trained for an Ironman triathlon this year. Maher, 38, had previously managed her plantar fasciitis with physical therapy, a Strassburg stretching sock she wore at night, trigger therapy on her calf, a step-stretch device, a foot roller —”you name the gadget, I’ve got it,” she said. But during a training run in March, the pain got increasingly worse until she felt something snap. The condition had turned chronic, and she couldn’t run for months.
Maher found salvation in radiofrequency technology, a new treatment in which probes are inserted into the skin to send high-energy sound waves into the tissue, stimulating blood flow to the area to kick-start healing. By July, Maher was running again, and she was able to compete in the Wisconsin Ironman in September. She missed her personal record by just five minutes.
“It’s still a little tender when I run, so now I’m trying to give it the rest I should have given it after I had the procedure,” said Maher, a brand marketing manager who lives in Naperville. “But I’m expecting to kick it.”
Another treatment for chronic heel pain is shock-wave therapy, a noninvasive procedure that sends sound waves through the heel skin. Less frequently used is surgery to cut the plantar fascia and relieve tension, which can cause complications.
Ideally, experts say, it should never get to that point, if people would just seek help early on.
“People ignore their feet too much,” Scheffler said.
Treatments for Burning Feet
The most important treatment for burning feet due to neuropathy is to stop any ongoing nerve damage. In some cases treatment of the underlying disease will improve the neuropathy and symptoms. In other situations, like a small fiber neuropathy, where no cause can be identified, the physician will focus on treating the person’s symptoms.
For people with diabetic neuropathy, treatment means keeping blood sugar levels in the normal range. This usually requires dietary changes, oral medications, and often insulin injections.
For people with other forms of neuropathy that cause burning feet, preventing further nerve damage is equally important. Specific conditions and their treatments include:
- Vitamin deficiency. Taking additional vitamin B12 orally or by injection can replace low levels of this nutrient.
- Alcoholism. Stopping excessive drinking prevents ongoing nerve damage and allows nerves to heal.
- Chronic kidney disease. Dialysis may be necessary to eliminate toxins causing neuropathy and burning feet symptoms.
- Hypothyroidism. Taking oral thyroid hormone raises low thyroid levels, often reversing neuropathy as well as burning feet symptoms.
GBS and CIDP. Treatments are very specialized and include plasma exchange (plasmapheresis) or immune globulin therapy (IVIG).
Burning feet treatments include treating the pain and abnormal sensations created by neuropathy. Some commonly prescribed medications for burning feet include:
- carbamazepine (Tegretol)
- desipramine (Norpramin)
- duloxetine (Cymbalta)
- gabapentin (Neurontin)
- pregabalin (Lyrica)
- topiramate (Topamax)
- venlafaxine (Effexor XR)
Other pain medications may be necessary to reduce the severe discomfort some people experience from burning feet. Over-the-counter medicines like Advil, Aleve, Motrin IB, and Tylenol control pain in many people with burning feet. Prescription pain relievers like tramadol (Ultram) or low-dose opiates (narcotics) may be necessary for severe pain.
For burning feet caused by athlete’s foot, antifungal drugs can cure the fungal infection and relieve burning feet symptoms. Over-the-counter medicines like miconazole (Micatin) or terbinafine (Lamisil AT) should be used first. Prescription antifungals like fluconazole (Diflucan), itraconazole (Sporanox), and naftifine (Naftin) are also available.
What is foot pain?
Pain in the foot can arise from a number of different causes. Foot pain may develop as a result of conditions affecting any of the structures in the foot, including the skin, nerves, muscles, joints, tendons, bones, ligaments, blood vessels, and connective tissue. Trauma or injury is a common cause of foot pain. Even everyday situations, such as overuse or poorly fitting shoes can lead to temporary, acute pain in the feet.
Foot pain can be described as sharp, stabbing, dull or throbbing. It can also feel like a tingling or burning sensation (paresthesia), which is common in conditions such as diabetes that can damage the peripheral nerves (peripheral neuropathy). Foot pain may be mild to severe in intensity and occur only at certain times of day or when you perform certain activities. Moving your foot or ankle may either worsen or relieve the pain. With severe pain related to traumatic injuries, it may be impossible to move the affected foot at all.
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In some cases, foot pain is localized. Yet even when the pain is restricted to one foot (unilateral), it may occur only on the top of the foot (dorsum), the bottom of the foot (plantar surface), the heel, the ankle, or the toes. Plantar fasciitis is an example of a condition in which pain is felt primarily at the bottom of the heel.
Foot pain may be recent in origin (acute) or develop over time (chronic). In some situations, foot pain can occur as a result of chronic medical conditions you may have that affect your entire body, such as arthritis, vascular disease, or diabetes.
Although life-threatening complications of foot pain are rare, seek immediate medical care (call 911) for injuries that involve profuse bleeding or tissue damage. In rare cases, infections of the bone (osteomyelitis) or skin and soft tissues (cellulitis) of the foot can spread throughout the body, resulting in shock and organ failure. Another rare but potentially life-threatening cause of foot pain is cancer of the bones or soft tissues in the foot.
If your foot injury or condition is persistent, recurrent, or causes you concern, seek prompt medical care.
What other symptoms might occur with foot pain?
Foot pain may be accompanied by other symptoms, depending on its cause and any underlying diseases or conditions. Some conditions that frequently affect the feet, such as peripheral vascular disease or diabetic neuropathy, can cause symptoms in other body systems.
Foot symptoms that may occur along with foot pain
Pain in the feet may accompany other symptoms affecting any of the structures of the foot including:
Bleeding or bruising
Burning or tingling sensation (paresthesia)
Difficulty moving the foot, ankle or toes
Swelling (edema) of the foot or joints
Other symptoms that may occur along with foot pain
Foot pain may accompany symptoms related to other body systems including:
Muscle cramps or spasm
Pain, swelling or stiffness of other joints
Serious symptoms that might indicate a life-threatening condition
In some cases, foot pain may occur with other symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:
Chest pain or pressure
Paralysis or inability to move a body part
Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not
breathing, or choking
Sudden change in vision, loss of vision, or eye pain
Sudden, severe headache
What causes foot pain?
Injury or damage to any of the structures in the foot can cause foot pain. Diseases that affect the entire body, such as diabetes, arthritis, or vascular disease, are more complex processes that can lead to foot pain.
Traumatic causes of foot pain
A number of common injuries can cause foot pain including:
Injuries related to overuse
Sprains and strains
Inflammatory causes of foot pain
Inflammation can cause foot pain that is restricted to one foot or even a specific location on one foot. Examples include:
Bursitis (inflammation of a bursa sac that cushions a joint)
Gout (type of arthritis caused by a buildup of uric acid in the joints)
Peripheral neuropathy (disorder of the peripheral nerves that lie outside your brain and spinal cord)
Plantar fasciitis (inflammation of the thick, fibrous tissue on the bottom of the foot)
Tendonitis (inflammation of a tendon)
Rheumatoid arthritis (chronic autoimmune disease characterized by joint inflammation)
Vasculitis (inflammation of the blood vessels)
Infectious causes of foot pain
Infectious processes can also cause foot pain including:
Cellulitis (skin and soft tissue infection)
Osteomyelitis (bone infection)
Plantar warts (caused by papillomavirus infection)
Other causes of foot pain
Foot pain can also be caused by problems that affect multiple body systems including:
Benign or malignant tumors
Buerger’s disease (acute inflammation and clotting of arteries and veins)
Diabetes (chronic disease that affects your body’s ability to use sugar for energy)
Loose fragments of bone or cartilage within joint spaces
Peripheral artery disease (PAD, also called peripheral vascular disease, or PVD, which is a narrowing of arteries due to a buildup of fat and cholesterol on the artery walls, which limits blood flow to the extremities)
Raynaud’s disease (spasms of small blood vessels of the fingers and toes, reducing blood circulation; has no known cause)
Serious or life-threatening causes of foot pain
Although life-threatening causes of foot pain are rare, all serious injuries, including foot injuries, should be immediately evaluated in an emergency setting.
Questions for diagnosing the cause of foot pain
To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your foot pain including:
How long has your foot pain been present?
Is your pain constant or does it come and go?
What other symptoms are you experiencing?
When do your symptoms occur?
Are your symptoms worsened or relieved by movement or specific activities?
What are the potential complications of foot pain?
Managing the underlying causes of foot pain can, in many cases, prevent the development of serious complications such as joint deformity, widespread infection, gangrene, or even amputation. Left untreated, long-term complications, such as infection throughout the body or gangrene of the feet, can be life threatening. Possible complications of untreated foot pain include:
Blood clot (thrombosis)
Sepsis (life-threatening bacterial blood infection)
Teachers, nurses, retail workers or cashiers, servers, mothers, runners and anyone else who has spent a great deal of time on their feet know the toll it can take on your body. You would do anything to soothe that aching, tender feeling in our feet after a long day on them. Standing on your feet without rest for long periods of time can lead to a wide variety of issues, especially if your posture is incorrect and your shoes provide inadequate support. Standing incorrectly can cause foot, ankle, and back pain as well as overall alignment issues.
As leaders in the custom footwear industry, the team at Wiivv spends countless hours researching foot pain and shoe comfort. Here are some “save your feet” hacks we’ve put together because you deserve to feel, move, and live your best all day. We’ve got your back, and of course, your feet!
Note: Always seek professional help from a medical expert such as a podiatrist or a chiropractor before doing any exercises or self-adjustments. Your best bet is to ask for a personalized exercise/adjustment plan that takes into account all factors like age, weight, lifestyle etc.
1. Proper Support
A common cause of foot and heel pain is Plantar Fasciitis, which can be caused by excessive standing in ill-fitting or unsupportive shoes. Plantar Fasciitis (PF) is the stabbing pain you feel under the soft part of your foot and around your heel.
Heel spurs can develop if PF is left untreated. Additionally, PF pain can cause inactivity, leading to lower quality of life and diminished health. Your body will also alter your gait to adjust to the pain you are experiencing which can potentially lead to additional alignment related issues in your body.
How can I fix it? Healing PF takes time, but proper arch support is key in relieving pain and assisting the process. Custom arch support is extremely effective in distributing pressure to your feet more evenly. Wiivv offers affordable custom insoles made for you, from your phone. These insoles have been scientifically proven to help relieve pain caused by plantar fasciitis and they provide long lasting comfort by distributing pressure across your foot, reducing pronation, and stabilizing your body from the ground up.
2. Stretch it out
Regularly practicing yoga can help you to gain and maintain better posture, as well as loosen and strengthen muscles throughout your body. Ask your yoga teacher for help to make adjustments to your posture that you can apply in and after class.
Try these specific yoga poses to help loosen your muscles and relieve foot and ankle pain:
- Downward facing dog
- Runner’s Stretch
- Hero’s Pose
- Bound Angle Pose
3. Ditch the flat flops
Turns out the world’s most popular footwear is horrible for your body. Flip flops are flimsy, flat, and provide no support to your feet. This lack of support can cause a great deal of pain – that’s why when you’re walking through Disneyland or travelling in Mexico your feet are aching by the end of the day. Continued lack of support, like what you experience with flip flops, can lead to inflammation of the plantar fascia and cause plantar fasciitis. If left untreated, this will cause a great deal of pain and over time your arch can begin to flatten out.
In addition to lack of support, wearing ill-fitting flops causes “toe scrunching” in an attempt to keep them on your foot better which can trigger tendonitis. Poor fit can also cause a change in your natural stride, which often leads to ankle, knee, hip or back issues.
How can I fix it?
Make sure you choose a pair of sandals that fit properly and provide adequate support. Here’s a basic checklist for your next pair:
- Size: Your sandals should fit you properly. Your toes and heels should be fully on footbed with nothing hanging over any edge.
- Flop: Your sandals should only bend at the ball of the foot. Bending in the middle of the footbed means a flimsy shoe AKA. poor support.
- Proper Support: A sandal with custom arch support will go a long way in preventing the aforementioned problems that come with flat flip flops. Wiivv makes comfortable sandals that provide proper support because they’re made custom to you. They are designed to provide custom arch support (even unique to your own left and right feet). These sandals are made based on 200 points digitally mapped from photos taken on your phone.
4. Take a circulation break
If you spend a majority of your day on your feet and/or in a stationary position, taking posture breaks are of important to promote circulation. Varying your position during the day can help ease the strain of repetition on your foot muscles. Circulatory sluggishness caused by gravity can make you feel tired, cause headaches, strain in your back muscles and can even negatively impact your mood.
How can I fix it? Try practicing exercises to improve circulation throughout the day. Three simple ones you can try while at work are rolling a tennis ball under your feet to loosen your hamstrings and alleviate foot pain, lunges to stretch your thigh and hamstring muscles, and rotating your ankles clockwise and counterclockwise to loosen the muscles and tendons in the leg and the joint around the foot.
6. Epsom Salt Soak
Epsom salt is a natural anti-inflammatory that can aid in treating muscle aches and epsom salt soaks are great for soothing aches and pains. Fill up a foot bath or shallow bucket with warm water and half a cup of epsom salt. Add a couple drops of an essential oil of your choice and soak your feet for as long as you would like.
5. Check your posture
Poor posture can have a dramatic effect on your muscles and ligaments. It can lead to pain and injury in your heels, knees, back, feet and even difficulty with digestion and breathing. Bad posture is typically caused, and made worse by, an imbalance in strength and tension within your muscles. The muscles in your feet play a huge role in this. For example, tight calf muscles paired with weak plantar fascia can wreak havoc on your gait and foot posture (the alignment of the foot itself). This poor posture is a vicious cycle, causing the body (which naturally leans slightly forward) to tilt further forward or backward, adding additional strain to your feet and heels, and making plantar fasciitis–and posture–worse.
How can I fix it?
It’s possible to improve your posture and reduce pain from the ground up by improving the overall alignment of your feet, correct your gait, and allow your body to align and move the way it was meant to. Using custom insoles in your shoes helps to distribute pressure and loading across the entire foot, reduce ankle rotation and keep you aligned from the ground up. Wiivv insoles are digitally mapped using over 200 points to create custom arches unique to each of your feet and provide you perfect fit comfort in all of your shoes.
American Chiropractic Society also offers the following tips for correcting your posture. Practice these consciously daily and overtime the corrections will gradually replace your existing posture.
- Bear your weight primarily on the balls of your feet.
- Keep your knees slightly bent.
- Keep your feet about shoulder-width apart.
- Let your arms hang naturally down the sides of the body.
- Stand straight and tall with your shoulders pulled backward.
- Tuck your stomach in.
- Keep your head level-your earlobes should be in line with your shoulders. Do not push your head forward, backward, or to the side.
- Shift your weight from your toes to your heels, or one foot to the other, if you have to stand for a long time.
Therapeutic massage is a great way to relax and loosen the muscles in your feet. Using both hands, press your thumbs up the center line of your foot in a circular motion. Use firm but gentle pressure, spending a little extra time on any tender pressure points you find.
Rolling the arches of your bare feet with a tennis ball can also be very effective in relieving soreness and pain in your feet. Do this by slowly roll your foot from side to side so the ball crosses your arch for 1 to 2 minutes, then roll the ball along the length of your foot from heel to toe for 1 to 2 minutes. Repeat on your other foot.
Plantar fasciitis is a very common foot condition that causes pain in the heel, across the sole of the foot and sometimes into the arch area of the foot. Foot pain is a normal part of life but if you are suffering it can be worrying and bring daily duties to a standstill. But it can be treated, and in most cases you can do this yourself at home or at work with the right advice.
The pain is caused by swelling of the plantar fascia which is a form of connective tissue that is very important to the biomechanics of the foot. This tissue connects the heel to the ball of the foot and supports the arch of the foot and takes considerable strain when standing, walking and running.
This condition can affect anyone but is more common in people over the age of 40. Overuse is the most common cause, as well as being overweight, or having altered biomechanics e.g. flat feet, high arches or tight calf muscles.
Plantar Fasciitis symptoms
Pain in the heel, across the sole of the foot (the part in contact with the ground) and possibly spreading to the arch of the foot. The pain is usually described as sharp, burning and aching and usually develops slowly and doesn’t go away. It is often at its worst when you first put weight through your foot, so more noticeable in the morning.
Pain can worsen as the day progresses or after long periods of standing and may feel as if the more you do the worse it becomes.
Why does it develop?
It can affect anyone but is more common over the age of 40. There are a number of theories as to why it develops, and includes factors such as overuse (prolonged standing or walking), being overweight and/or altered biomechanics. Occupation can also influence its development, ie completing a shift whereby you are stood for 8 hours.
How do I manage my Plantar Fasciitis?
As with many foot and ankle pains it can be treated yourself at home or work without having to see a Physiotherapist or Podiatrist.
Rest and modified activity – for most people keeping off your feet isn’t an option. For this reason alone the pain may take some time to fully resolve, but by trying to reduce activity levels in the first instance, and then gradually increasing them as the pain improves, will aid your recover. You should use your pain to monitor your progress, for instance if your pain is worse in the morning, reduces quickly after taking a few steps, and is absent for the remainder of the day you know you are on the road to recovery. If you have increased your activity and the pain then takes longer to decrease the next day you can be confident that you have over done it and make changes accordingly.
ICE (Cryo-therapy) and massage – it may be tender initially but try massaging the heel and arch area of the foot. This should become comfortable over time as the areas around the plantar fascia spasm less the tenderness will reduce. You can simply use your fingers to do this, or ask someone else, or even use something like a rolling pin or golf/tennis ball over the area.
Do this a couple of times a day for approx 5 minutes. Afterwards the heel may feel tender and now would be a good time to consider using ice on the area for 5 -10 minutes in order to get maximum affect. You ,may choose to combine the two by using a frozen water bottle.
Stretching – stretching the foot and ankle has also been proven to be effective in treating the condition. Stretching should not be painful and you should hold the stretch for at least 30 seconds. As you stretch the resistance will begin to ease as the tissues in the foot start to give. You should repeat the stretches approx 5 times and aim to repeat all stretches a couple of times a day at least. Example stretches can be seen below
Poor footwear – can be a contributing factor so it is important to consider the appropriateness and condition of your current footwear and make changes as necessary. Footwear should;
- Fit well
- Not excessively compress the feet
- Have a cushioned sole
- Be supportive
For more information please see our footwear information.
Insoles or Orthotics – these can be useful in aiding your recovery and can be purchased from a range of pharmacies and sport shops. Over the counter insoles will primarily aim to cushion your heel and support your arches. You may, in the first instance, choose to try some felt or similar material to see if additional support provides any relieve or increased comfort.
Remember if your symptoms continue without improvement or are getting worse as your GP to refer to PhysioHey and we will provide you with advice, reassurance that you’re doing the right thing, or invite you in to review the situation and help get you back on track. If you do need to attend for treatment you will still need to complete your exercises at home and it is this combined approach that will be key to resolving your foot pain.
Plantar fasciitis 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. Ask your doctor how much exercise you should do.
- If you have high arches, talk to your doctor 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 obese, 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.
Stretching exercises for your feet and legs are important. Do the stretches shown here at least twice a day. Do not 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 family doctor before you start a new medicine.
If the first few steps you take in the morning are painful, you might be experiencing plantar fasciitis. It’s one of the most common causes of foot pain, with 2 million to 3 million patients seeking medical treatment each year, said Dr. Michael Greaser, an orthopedic surgeon and assistant professor at McGovern Medical School at The University of Texas Health Science Center at Houston. Many of the patients typically seek treatment after having months or years of heel pain. There are most likely many others who have plantar fasciitis that never seek treatment.
The stabbing pain that is felt is caused by inflammation of a band of tissue known as the plantar fascia that connects the heel bone to the toes. The pain is normally localized near the heel but can be felt anywhere along the plantar fascia ligament, according to Dr. Dominic Catanese, professor and chief of podiatric surgery at Montefiore Medical Center at Albert Einstein College of Medicine in New York.
The pain tends to beworse first thing in the morning and after long periods of sitting or standing. When there is no weight put on the foot, the ligament shortens and tightens, Catanese said. Then when the patient stands, the sudden stretching of the plantar fascia with the added weight may result in pain. Usually the pain subsides after a few minutes of walking and stretching.
Causes and diagnosis
There are many reasons why one might develop plantar fasciitis, according to the American Orthopedic Foot & Ankle Society. Some of these factors include being overweight, being on your feet for extended periods and wearing shoes with inadequate support. In addition, impact exercises such as running, tight calf muscles that limit ankle mobility, flat feet or high arches, excessive pronation (when the foot rolls severely inward when walking) or wearing high heels on a regular basis can be aggravating factors.
Heel spurs are commonly thought to cause plantar fasciitis, but the opposite is more likely to be true, Greaser said. A heel spur is the bony outgrowth on the edge of the heel that’s often the result plantar fasciitis, but it’s rarely the cause of heel pain.
To diagnose plantar fasciitis, a doctor will question the patient about their pain and examine the foot, including looking for areas of tenderness, the height of the arch and ankle mobility, according to the American Academy of Orthopedic Surgeons (AAOS).
Imaging tests such as X-rays or MRIs may also be used to rule out other potential causes of foot pain, such as fractures or arthritis.
According to Catanese, there are three main ways to treat plantar fasciitis: stretching the plantar fascia and the muscle group in the back of the leg, using good quality and supportive shoes or orthotics, and reducing inflammation. More than 90 percent of people with plantar fasciitis experience a significant reduction in pain after less than a year of treatment.
Stretching is the single most important thing to do to eliminate and prevent pain, Catanese told Live Science. According to AAOS, two of the most important stretches are for the calves (place one leg in front of the other with the front leg bent, both heels on the ground, and lean into the wall) and the plantar fascia (from a seated positing, cross the foot with plantar fasciitis over the knee of your opposite leg and carefully stretch the toes towards your body). Doctors recommend taking a break from high-impact exercises like running and switching to low-impact exercises like swimming or yoga.
Over-the-counter anti-inflammatory medications such as ibuprofen or a steroid injection are other ways to reduce the inflammation and associated pain. Ice and massage are also used to reduce inflammation.
Another option is to use splints at night to stretch the plantar fascia while sleeping. Physical therapy and extracorporeal shock wave therapy, which sends high-energy pulses to stimulate the plantar fascia, may also promote healing.
If none of those options improve plantar fasciitis, more invasive options are available. Common surgical options include removing scar tissue around the plantar fascia, partially removing the plantar fascia from the heel, or surgically lengthening the calf muscles.
Don’t ignore it
If plantar fasciitis remains untreated, chronic heel pain can develop with irreversible consequences, including scarring and thickening of the plantar fascia at its origin in the heel, Greaser said. The ligament could also become partially or completely ruptured if a person with plantar fasciitis continues their high-impact activities.
Some cases of chronic heel pain have also been found to develop into distal tarsal tunnel syndrome, similar to carpal tunnel syndrome in the wrists, where the nerves running along the bottom of the foot can become entrapped. According to Johns Hopkins Medicine, symptoms can include shooting pain, a tingling or burning sensation, or numbness.
The feet are relatively small body parts that experience significant pressure and stress on a daily basis for most people, according to the Institute for Preventive Foot Health. For that reason, it’s important to make sure your feet stay healthy and be aware of the symptoms of foot conditions such as plantar fasciitis.
- The Mayo Clinic’s guide to plantar fasciitis
- U.S. National Library of Medicine guide to plantar fasciitis
- The Plantar Fasciitis Organization
This article is for informational purposes only and is not meant to offer medical advice.
Plantar Fasciitis Treatment
Your treatments may include:
- Icing the area.
- Night splints. You wear these to stretch your calf and foot while you sleep.
- Physical therapy. Certain exercises can stretch your fascia and Achilles tendon and strengthen your leg muscles, which will make your ankle and heel more stable.
- Rest. Stop doing things that make the pain worse. This might include some types of exercise, like running or jumping.
- Supportive shoes or inserts. Shoes with thick soles and extra cushioning will make it less painful for you to stand or walk. Arch supports can distribute pressure more evenly across your feet.
- Taking pain-relieving non-steroidal anti-inflammatories (NSAIDs) like ibuprofen or naproxen sodium. You shouldn’t take these for more than a month, so talk with your doctor.
Once you begin treatment, you’ll usually see improvement within 10 months. If you aren’t better then, your doctor might try treatments like shots of cortisone, a type of steroid, to ease inflammation. In rare cases, you might need surgery.