Heel pain can sneak up on you. One day you are feeling fine, and the next, you can barely walk across the kitchen without it feeling sharp, stiff or downright painful – the telltale sign of plantar fasciitis, one of the most common causes of heel pain near the arch of the foot.
Whether you’re a runner, a weekend adventurer, or just someone who enjoys staying active, understanding plantar fasciitis can help you manage and prevent this painful issue. Below we explain what plantar fasciitis is, how it develops, and what you can do about it.
What is plantar fasciitis?
Plantar fasciitis is the inflammation of the plantar fascia – a tough fibrous band that runs along the bottom of the foot. It connects the calcaneus, or the heel bone, to the base of the toes. Plantar fascia supports the arch of the foot and plays an important role in normal foot mechanics during walking or running.
When the plantar fascia becomes irritated or overstressed, it can lead to plantar fascia pain felt near the heel or the arch.
How does the plantar fascia work?
When you walk, the plantar fascia plays a crucial role in supporting your arch and absorbing shock. As your heel strikes the ground, the plantar fascia stretches slightly to help cushion the impact. When you shift your weight forward and push off with the ball of your foot and toes, the plantar fascia tightens to give your foot stability and strength. This stretching and tightening action helps your foot move smoothly and efficiently with each step.
Over time or with excessive use, the plantar fascia can lose some of its elasticity, becoming irritated, inflamed, leading to heel pain, even during routine daily activities.
What causes plantar fasciitis?
There are several common causes for plantar fasciitis, including:
- Overuse or sudden changes in activity level: Suddenly starting activities, like a walking or running program, or participating in repetitive exercises without proper preparation can put added stress on your plantar fascia.
- The structure or shape of your foot: Flat feet, high arches, or an abnormal walking pattern can put extra stress on the plantar fascia.
- Wearing ill-fitting shoes: Shoes that lack proper arch support or cushioning can contribute to plantar fasciitis.
- Carrying too much weight: Extra body weight increases the strain on your feet.
What are the symptoms of plantar fasciitis?
The most common symptom of plantar fasciitis is heel pain, which can be dull and aching or a sudden, sharp pain. This pain often worsens over time, but in some cases, it can appear suddenly after an awkward step or movement.
Pain is typically worse after returning to activities after prolonged periods of inactivity or first thing in the morning and can feel worse when walking barefoot or wearing shoes with minimal support. Sometimes, the level of discomfort can decrease after warming up or completing activities throughout the day.
How to prevent plantar fasciitis and heel pain
Taking steps to prevent plantar fasciitis and heel pain can help protect your feet and reduce strain on the plantar fascia. It starts with caring for your feet and paying attention to your body’s signals. Here are some tips to reduce your risk:
Wear Supportive Shoes: Choose shoes with good arch support and cushioning, especially if you spend a lot of time on your feet or are starting a new fitness activity that may add stress to your arches.
Replace Worn-Out Shoes: Athletic shoes lose their cushioning over time. According to the Academy of Podiatric Sports Medicine, shoes should be replaced when they:
- Have logged 300-500 miles of running or walking, or 45-60 hours of high impact activity, like basketball, aerobic dance or tennis.
- Appear uneven when placed on a flat surface.
- Display noticeable creasing.
Increase Activity Gradually: If you’re starting a new exercise routine, increase your activity level gradually to avoid overloading your feet.
Stretch Regularly: Stretching the calves, Achilles tendon, and plantar fascia can improve flexibility, reduce tension and can lower the risk of recurring plantar fascia pain. Great stretches to try are toe stretch, calf stretch, and rolling a tennis ball under the arch of your foot.
Listen to Your Body: If you experience foot pain, don’t ignore it. Take a break and address the issue before it becomes a chronic problem.
How do you treat plantar fasciitis?
Treating plantar fasciitis often begins with conservative care focused on reducing inflammation, relieving heel pain, and supporting the plantar fascia. Here are some effective strategies:
Home Care
- Rest: Give your feet a break from activities that cause pain. Avoid running, jumping, or prolonged standing until the pain subsides.
- Ice: Apply ice to the painful area for 15-20 minutes several times a day to reduce inflammation, this can be done by rolling a frozen water bottle under your foot.
- Stretching: Gentle stretching exercises for the plantar fascia, Achilles tendon, and calf muscles can help relieve tension and improve flexibility.
- Footwear: Wear shoes with good arch support and cushioning. Avoid walking barefoot on hard surfaces.
Medical Treatments
- Physical Therapy: A physical therapist can teach you exercises to strengthen your foot muscles, improve flexibility, and reduce pain.
- Orthotics: Custom or over-the-counter shoe inserts or heel cushion inserts can provide extra support and cushioning for your feet.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation.
- Corticosteroid Injections: For more severe instances, your doctor may recommend corticosteroid injections to reduce inflammation and pain.
- Surgical Release: In rare cases, surgery may be considered if symptoms do not improve after months of conservative treatment.
When to See a Doctor
Most cases of plantar fasciitis can be managed with home care and lifestyle changes, but persistent heel or arch pain should not be ignored. If your symptoms are interfering with daily activities, professional treatment may be necessary. See a doctor if:
- Your pain doesn’t improve after a few weeks of home treatment.
- The pain is severe or affects your daily activities.
- You notice swelling or redness in your heel or foot.
- You have difficulty walking or standing.
To schedule an appointment with an NGPG Orthopedic & Sports Medicine provider