About plantar fasciitis
plantar fascia is the thick band of
tissue that covers the bones on the bottom of the foot.
Plantar Fasciitis is the most common cause of heel pain. It
occurs when the plantar fascia on the bottom of the foot
stretches irregularly and develops small tears. These
small tears cause the fascia to become inflamed. This
commonly occurs in athletes and middle-aged adults.
The Causes of Plantar
fasciitis: Tight tendons at the back of the heel, tight calf
inward twisting or rolling of the foot (pronation), high arches,
and flat feet can lead to plantar fasciitis. Excessive pronation, which can cause
tension in the plantar fascia as the arch lowers during standing or
walking, has been found in about 85% of people with plantar
Repetitive stress on the ligament, such as jobs or
activities that require prolonged walking, running or standing on hard or
irregular surfaces can result in plantar fasciitis. Aggravating factors include obesity and poorly
cushioned and improperly fitted shoes.
The natural process of aging also contributes to this condition.
In rare cases, a single traumatic injury to the foot can result in
This condition is commonly thought of as being caused by a heel
spur, but research has found that this is not the case. On X-ray, heel
spurs are seen commonly both in people with and without plantar
|Symptoms & Progression of Symptoms
Plantar fasciitis usually develops gradually. Initially, heel pain may only occur
when taking the first steps after getting out of bed or after sitting
for a long period of time. As plantar fasciitis
progresses, the heel pain gradually gets worse. You may change the way
you walk to relieve the pain. This eventually may lead to more
discomfort and pain and other foot, leg, hip, or back problems.
Over time, there may be pain with all weight-bearing activity. A heel spur may form as a result of
continued stress as the plantar fascia pulls on the heel bone. If the condition is not treated, plantar fasciitis can cause
constant heel pain while standing or walking. The longer you let heel pain go unresolved, the more likely it will become a chronic and untreatable problem.
If you do not rest the plantar fascia ligament, the inflammation and
heel pain will get worse. Other conditions or aggravating factors, such as
the repetitive stress of walking, standing, running, or jumping, will
contribute to inflammation and pain. The inflamed ligament may never heal
completely if you are not able to stop the aggravating activity.
1) Rest your foot. Try to stop any activities that may be aggravating
heel pain. Avoid exercise that involves repeated motions and pounding of the
foot against a hard surface such as running or jogging.
2) Arch support and heel cushioning Wear supportive footwear with sufficient arch
support and heel cushioning. Orthotics (shoe inserts) can be bought or custom made for a more accurate fit. A prescription is not necessary for orthotic purchases. Orthotics can reduce stress
and pulling on the plantar fascia ligament. Always wear shoes when you
get out of bed, even if it is just to go to the bathroom. Wear rubber flip flops in the shower. Walking in bare feet on ceramic tile and cement greatly aggravates plantar fasciitis.
3) Use ice (20-minutes with an ice pack or 10-min at a time with
ice directly on the area in a pillow case) to help
reduce inflammation. Contrast baths, which alternate hot and cold water, can
also be helpful in reducing inflammation. It is important to end a contrast bath with a soak in
4) Take nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce
inflammation and pain.
5) First thing in the morning: Stretch your foot by
flexing it up and down 10 times before standing. Use a towel to
stretch the bottom of your foot (towel stretch). Massage the
bottom of your foot across the width of the plantar fascia
before getting out of bed.
6) Before exercise or walks it is very important to warm up and do
stretching exercises. Warm up with a slow walk for about 10 minutes,
then do one of the stretches listed below prior to a long walk or workout.
Warm up and stretching will increase the
flexibility in your plantar fascia and decrease the chance of injury and
7) After exercise or any activity that flares up the symptoms, ice your heel (for 20 min with a thin towel
under an ice pack, or 10 min at a time with ice directly on the
area in a pillow case) to help relieve
pain and inflammation.
8) A regular routine of stretching and strengthening exercises for the foot (see below) is extremely helpful in relieving pain and preventing recurrence of pain from plantar fasciitis.
Stretching and strengthening exercises
will help treat plantar fasciitis
Stretching exercises: Do not bounce; stretching should create a pulling feeling and
should not cause pain. Also, stretching should be done after 10 minutes of gently warming up the muscles, such as slow walking. Trying to stretch cold muscles is like trying to stretch cold gum.
1) Calf stretches. To stretch the Achilles tendon, lean forward
against a wall, keep one leg with the knee straight and heel on the ground
while bending the knee in the other leg. Hold this position for 30 seconds,
then switch legs. Try to do this stretch 3 to 6 times a day, or
2) Use a towel to stretch: Place the rolled towel under the
center of your foot, holding the towel at both ends, and gently pull the
towel toward you, keeping your knee straight, until you feel a stretch
either in your calf or the bottom of your foot. Hold this position for at
least 30 seconds.
3) Combination plantar fascia/calf stretch. Stand on a step with only the
front part of your feet touching the step. While holding onto the
rail, slowly lower your heels. Hold this stretch for 30 seconds, then bring
your heels back to a level position. Repeat this stretch 3 times.
4) Use a rolling pin, can of soup (lying on its side) or a tennis ball.
While seated, roll the rolling pin, can or ball with the arch of your foot.
Progress to doing this exercise while standing as you can tolerate it.
1) Towel curls. While sitting, place your foot on a towel on the
floor and scrunch the towel toward you with your toes. This exercise is best
done on a smooth surface, such as a linoleum or hardwood floor, so the towel
slides easily. After you pull the towel toward you, push it away again with
your toes. This helps to give the different muscles in your foot a balanced
workout. As your foot gets stronger, place a soup can or other weighted
object on the far end of the towel.
2) Marble pickups. Put marbles on the floor next to a cup. Using your
toes, try to lift the marbles up from the floor and put them in the cup.
|Physical Therapy is helpful in treating plantar fasciitis
Physical therapists are well-trained in foot and ankle disorders. Therapists use a wide range of treatment modalities to decrease inflammation, relieve the pain, and initiate an exercise program to treat the cause of the problem and prevent recurrence.
| Painful Heels from the Arthritis Foundation
fasciitis at Medline Plus, A service of the Nat'l
Library of Medicine and the National Institutes of Health.
BAMI is an up-to-date educational source for patient education. Health care providers may feel free to print out copies for their patient's use. Please note that content may not be copied for resale or other commercial use such as for web sites. The content on this site is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Never disregard professional medical advice or delay in seeking it because of something you have read on this site.
Display of an advertisement does not imply an endorsement of the product.
©2015 Bay Area Medical Information (BAMI.us)™ All Rights Reserved
Google | Yahoo | MSN | AOL | Netscape | Earthlink | Dogpile | All the Web | AltaVista