Everyone has heard of the term “plantar fasciitis” before. You may have had friends or family members suffer from this condition in the past. But what exactly is plantar fasciitis? If you are currently dealing with sharp pain in the bottom of the foot or heel, you may be wondering what causes this inflammation and about the best course of action to treat this issue.
What Is Plantar Fasciitis?
Plantar fasciitis is a very common condition that accounts for over 10% of all running injuries and over 15% of all foot-related issues that require medical care in the general population. The plantar fascia is a thick band of connective tissue that runs from your heel to your toes and helps support the arch of the foot with walking and weight-bearing activities. When excessive stress is placed on this tissue without adequate time for recovery, the fascia can become inflamed and lead to very sharp foot pain that is often worse in the early mornings. Every person is a unique individual with different foot types, body mechanics, and flexibility.
Plantar Fasciitis Causes
There is no one right way to treat plantar fasciitis due to the dynamic nature of the human body, but here are some of the most common reasons for the onset of inflammation that we see here in the clinic.
Too Much Too Soon
This is the most common reason that leads to most of our runners and cleat sports athletes having arch and heel pain. If a patient has only been running 3 miles a few times a week but then attempts to run a half marathon without adequate training, this can lead to acute inflammation and micro-tearing of the fascia. Just like other muscles and tendons, the plantar fascia needs to be strengthened and gradually introduced to high levels of activity.
Abnormal Foot Mechanics
Every person’s foot and walking gait are unique; most of the time the only thing you can blame for your foot type is your genetics. The most common foot type that is at higher risk for developing fasciitis are those with a flat and collapsed arch. These patients pronate very heavily, which means that their foot is always flat and flexible and never able to properly lock up. The plantar fascia is always on excessive strength and never given a chance to recover. However, the opposite is also true: a patient with very high arches with a rigid foot may also be dealing with fascial pain due to their foot not being able to properly absorb the weight of their body when walking.
Excessive Stiffness of the Foot, Ankle, and Hips
Sometimes the area of the body that is injured may not be the root cause of the pain. Excessive stiffness and rigidity of the ankle joint, calf muscles, hamstrings, or hip joint can all lead to altered walking/running mechanics and eventually inflammation of the arch of the foot.
Footwear That is Too Tight
Most modern footwear is made more for aesthetics as opposed to function. Our toes and feet are made to naturally spread out, grip the floor, and adapt to the ground. If you are often wearing shoes that feel too tight and cause cramping in your arches (such as high heels, soccer cleats, converse, etc. ) this can easily lead to excessive tightness and strain on the plantar fascia.
Plantar Fasciitis Symptoms
Patients with plantar fasciitis have reported both dull and stabbing pain on the bottom of their heels. Other symptoms include:
Pain after exercise instead of during
Pain in the morning or after a period of inactivity
Foot arch pain
Long-lasting pain
Swollen heel(s)
A tight Achilles tendon
Plantar Fasciitis Treatment
Due to the multitude of reasons that cause plantar fasciitis, the treatment of this issue should also never be a cookie-cutter approach. If you or a friend have been dealing with arch or heel pain that just doesn’t seem to be going away, consider being evaluated by a PT or a movement specialist who can observe your body mechanics and specific foot issues to come up with an individualized treatment plan!
However, here are a few general exercises that work for heel pain.
Gastroc Stretch
1. Place your hands against a wall with your affected foot back to create a lunge stance, toes facing toward the wall.
2. Lean into the wall until you feel a stretch in the calf, keeping the back leg straight. Hold for 30 seconds.
3. Repeat the stretch 3 times in a row, 3 times a day.
You can also do a variation of this stretch, the soleus stretch, where both legs are bent.
Plantar Fascia Stretch
1. Position your unaffected foot flat on a step. Place your other foot on the edge of the step, standing on the ball of your toes.
2. Lower the heel of the affected foot to feel a stretch in the arch of your foot. Hold for 30 seconds.
3. Repeat this stretch 3 times in a row, 3 times per day.
Intrinsic Muscle Stretch
1. Sit down with your legs crossed, the affected foot over the knee of the other leg.
2. Grab your toes and pull them upward to stretch the arch and calf muscles. Hold for 30 seconds.
3. Repeat this stretch 3 times in a row, 3 times per day.
Other Treatment Options
Custom orthotics are highly beneficial when treating plantar fasciitis. They improve function and reduce pain by minimizing pressure and aligning your body properly. Orthotics are specially-made devices to support your feet, like Dr. Scholl's inserts but custom-made for you. These orthotics target abnormalities such as flat feet, high arches, or any other foot/leg issue that causes pain. Rehab United offers custom orthotics! If you feel like orthotics can benefit you, reach out to us through our contact form at the bottom of our homepage.
Interested in Physical Therapy for Plantar Fasciitis?
Here at Rehab United, we care about our patients; we want to see you thrive and get back to the things you love. From the front desk to the physical therapists, our staff is full of wonderful and empathetic people dedicated to giving you the best care possible. We will support you throughout your entire recovery journey, don't wait, schedule an evaluation today!
Chris Cheek,PT, DPT, CSCS, is a physical therapist who received his Doctorate of Physical Therapy at the University of Florida. Chris is also well-versed in programming for high-level athletics and sport as he obtained his Certified Strength and Conditioning Specialist (CSCS) certification through the NSCA.