Plantar Fasciitis

Plantar fasciitis is a painful condition affecting the bottom of the foot. It is a common cause of heel pain and is sometimes called a heel spur. Plantar fasciitis can come from a number of underlying causes. Finding the precise reason for the heel pain is sometimes difficult. Even so, several options are available for treatment.

What is Plantar Fasciitis?

The plantar fascia is a structure that runs from the front of the heelbone (calcaneus) to the ball of the foot. This dense strip of tissue helps support the arch of the foot by acting something like the string on an archer's bow.

As you can imagine, when the foot is on the ground a tremendous amount of force (the full weight of the body) is concentrated on the plantar fascia. This force stretches the plantar fascia as the arch of the foot tries to flatten from the weight of your body. This is just like the string on a bow is stretched by the force of the bow trying to straighten. This leads to stress on the plantar fascia where it attaches to the heelbone. Small tears of the fascia can result. These tears are normally repaired by the body.

As this process of injury and repair repeats itself over and over again, a bone spur (a pointed outgrowth of the bone) sometimes forms as the body's response to try to firmly attach the fascia to the heelbone. This appears on an X-ray of the foot as a heel spur.

Inflammation of the Plantar Fascia

Plantar fasciitis is an inflammation of the plantar fascia, the band of connective tissue that runs from the heel to the base of the toes. When placed under too much stress, the fascia stretches, causing intense pain and inflammation at the heel. Here is a list of features, symptoms, and conservative treatment options:

• Common cause of heel pain
• Frequently occurs in athletes
• Men and women affected equally
• Symptoms are bilateral in 10% of patients
• Symptoms of plantar fasciitis
  • Pain on the bottom of the heel
  • Pain is worse with first steps in the morning
  • Pain is worse with weight bearing after sitting
  • Pain is worse with activities of daily living
  • Tenderness over the plantar fascia
  • Pain is worsened by dorsiflexion of the toes
• Conservative (non-surgical) treatment for plantar fasciitis
  • Rest
  • Ice
  • Massage
  • Taping
  • Orthotics
  • Night splints
  • Shoe medication
  • Plantar fascia stretching
  • Achilles tendon stretching
  • Pain is worsened by dorsiflexion of the toes