Plantar Fasciitis Explained

Pain Patients: Learn about Plantar Fasciitis

Woman holding feet while stretching
webphotographeer/Getty Images

Plantar fasciitis, commonly known as ‘jogger’s heel’, is a common cause of pain in the heel. Damage and inflammation to the tissue in the foot, known as the plantar fascia, causes pain that radiates to the arch of the foot.

Introduction

The onset of pain is usually gradual and sufferers may experience pain beneath the heel which can spread throughout the foot. The underside and inside of the heel are often tender, and the pain is often most severe in the morning before the foot has had a chance to warm up.

Short-term pain can be exacerbated in the evening or after exercise. Flexing and stretching the foot can also be painful.

Runners whose feet roll or flatten too much when they step have a higher risk of plantar fasciitis due to excessive stretching when the foot flattens. People with high arches are also at risk because of the lack of ability for shock absorption and adaptation to the surface they are walking on. Having tight calf muscles is another factor that can eventually cause either a low arch or a high arch. Not wearing supportive footwear, or wearing heels that hyperextend the foot, have both been attributed to plantar fasciitis. Being overweight causes excess weight on the foot that also contributes to the injury. Previous plantar fascia injury can lead to the development of plantar fasciitis.

There are many treatments which can ease the discomfort of plantar fasciitis. To ensure a proper recovery, the origin of the condition has to be corrected and symptoms must be treated.

Rest and Ice

If possible, try to rest the foot until the pain has subsided. It is nearly impossible to stay off the foot and continue daily activities, so be sure to wear comfortable, supportive shoes with a gel cushioning to alleviate symptoms. Ice can also work to decrease swelling in the tissues.

Night Splint

Wearing a plantar fasciitis splint at night can help treat the condition. It works by keeping the fascia from tightening up overnight. Without the brace, the tendon tightens up, causing pain in the morning until the foot gets warmed up.

Exercises

If necessary, rehabilitation may be useful. Stretching out the fascia is important to treat and prevent the condition. Simply alleviating the pain will not result in a lasting recovery. When the fascia tightens up, it causes more stress on the attachment at the heel. Strengthening exercises can prevent future injuries, but stretching is important initially.

Medication

Prescribed anti-inflammatory medication can help moderate pain and inflammation. Creams and other topical painkillers are also recommended.

Massage

A deep tissue massage can reduce tension and stretch the tendon and the calf. Self-massage can be performed by rolling a tennis ball beneath the arch.

Imaging

Your doctor may recommend an ultrasound to determine if the fascia is thickening. To check for bone growth or heel spur, you might need an ultrasound, but this may not be what is causing the pain.

Injection

Corticosteroid injection is a possible treatment, but it runs the risk of rupture and deterioration of the fat cushioning pad underneath the heel.

Surgery

If symptoms don’t let up, then surgery may be a necessary option.

Conclusion

The plantar fascia is a band of tissue that attaches beneath the heel to the underside of the front part of the foot. It can become painful where it attaches to the heel if the fascia becomes damaged due to overuse or a tear. Until recently, the pain was thought to be due to inflammation of the muscles in the area, but further research suggests that deterioration of the collagen fibers near the attachment at the heel is the true cause of the pain.

Typically, overuse strains on the collagen fibers near the where the fascia connects to the heel. Continuous over-stretching of the tissue causes the tendon to thicken and damages the surrounding fibers. The bulked tendon causes a decrease in strength and flexibility. This injury is common among athletes involved in running, jumping and dancing.

Continue Reading