What is plantar fasciitis?

Plantar fasciitis is described as the result of increasing strain on the plantar fascia (can link to a section that describes what the plantar fascia is) as it inserts on the inside aspect of the heel bone.

Plantar fasciitis is an inflammation of the plantar fascia. “Plantar” means the bottom of the foot, “fascia” is a type of connective tissue, and “itis” means “inflammation”. It is often called heel spur because it is easier to say and remember. Heel spurs are soft, bendable deposits of calcium that are the result of tension and inflammation in the plantar fascia attachment to the heel. The plantar fascia encapsulates muscles in the sole of the foot. It supports the arch of the foot by acting as a bowstring to connect the ball of the foot to the heel. When walking and at the moment the heel of the trailing leg begins to lift off the ground, the plantar fascia endures tension that is approximately two times body weight.   This moment of maximum tension is increased and “sharpened” (it increases suddenly) if there is lack of flexibility in the calf muscles.

Where will the pain be?

Those suffering from plantar fasciitis typically present with pain on the inside (medial) aspect of the heel.  The onset of pain may be sudden or may have increased over time. The pain is usually in the front and bottom of the heel, but the definition of “plantar fasciitis” indicates it can be over any portion of the bottom of the foot where the fascia is located.  Patients often report that the pain “moves around.” The pain can be mild or debilitating. It can last a few months, become permanent, or come and go every few months or years for the rest of a patient’s life with no obvious explanation.

When will I feel the pain?

Most often patients complain of pain first thing in the morning or following periods of rest however others are aware of the pain on walking or when playing sports.

Unfortunately, it can take 12 to 36 hours after harmful activity before the pain increases, so it is not usually obvious what activity is causing an increase in pain. For example, a runner may not know if it was a recent change in shoes or changing to a terrain with hills that is causing an increase pain. But since a lack of flexibility in the calf muscles and/or excess weight are the causes of most cases, it is not usually a particular activity that can be blamed.

How is plantar fasciitis linked to foot position?

Plantar fasciitis is associated with over pronation of the foot (create link) although can also be associated with a supinated or under pronated foot type.  Over pronation of the foot is lowering of the long arch of the foot which results in an increase in tension of the plantar band that runs under the arch of the foot.  This increase in pull of the plantar band results in increased stress at the point of insertion under the heel where this band attaches to the heel bone.

How do I relieve the pain of plantar fasciitis?

• Better shoes with an arch support, more cushion, good flexibility in front of the shoe that allows the toes to bend back easily, and a raised heel. Flexibility in the front of the shoes decreases the amount of calf muscle flexibility that is needed. Stated another way, stiff shoes require more flexibility in the calf muscles by increasing the “effective length” of the foot which requires the foot to bend back further when walking. But if the foot can not bend back that far, it translates into tension in the Achilles tendon and plantar fascia.
• Heel Pads may benefit some cases just by being soft, but for many, heel pads help by having a raised heel because the raised heel compensates for inflexible calf muscles.
• For walkers and runners. Stretch before activity, no hills, shorter strides, no flat or stiff shoes, and ice immediately afterwards. Longer strides, hills, stiff shoes, and flat shoes require the foot to bend back further which translates into more tension in the plantar fascia and Achilles tendon.
• Arch support is often recommended by doctors for relief and can help if you are looking for an insert with the thickest and best cushion. Contact us today to see our selection of arch supports.

Find out how The Foot and Leg Clinic can help you with you foot and leg pain. Contact us today.