Plantar Fasciitis

What is plantar fasciitis?

Plantar fasciitis is inflammation of the plantar fascia where it meets the heel. Plantar fascia is a band of thick tissue on the bottom of the foot that helps to provide support to the foot and arch of the foot.

You can feel pain in the heel, often worse after resting such as first thing in the morning or after sitting for a long time. You can also feel pain when walking for long stretches. 

Why does this occur?

These factors can cause plantar fasciitis:

• Increase in activity level, like starting a running program.

• Tightness of muscles in your calf.

• Obesity.

• A lot of standing on hard surfaces at work.

Heel spurs do not cause plantar fasciitis.

What are the symptoms?

You will have pain in the heel, often on one side only but can occur on both sides. The pain comes on slowly. It is often worse with the first few steps in the morning or after lots of time on your feet standing or walking. It can last for months.

What is the prognosis?

Symptoms can be slow to improve, up to 6 to 12 months for some people but seeking proper treatment and guidance from your Doctor and a Physical Therapist can help to improve symptoms and reduce the duration of plantar fasciitis. More than 90% of people improve with non-surgical treatment. 

How can this be treated? 

There are some things that you can do to treat symptoms:

• Change to activities such as swimming or biking that reduce the amount of weight you must bear.

• Perform motion and stretching of the foot and ankle before getting up in the morning or after sitting for a long time. 

• Purchase an insole for your shoes that supports your arch.

• Try to lose weight.

• Visit your doctor or a physical therapist.

What exercises can I do?

Calf stretch: Stand, leaning against the wall with both hands. Put one foot ahead of the other. Keep the back foot pointing straight ahead, with the heel down and your knees straight. Shift your weight forward by bending the front knee then hold. Feel the stretch behind the knee and down the back of the lower rear leg. Repeat, but this time bend the back knee as well, with your heel still on the floor. Hold. You’ll feel the stretch lower down the back of the rear leg. Switch and repeat with the other leg. 

Foot/arch stretching: Sit with your affected leg crossed across your other knee. Gently apply pressure on the big toe to create a stretch of the big toe and sole (bottom) of the foot.

What can the doctor do to help?

Often, over-the-counter heel-supports or cushions are helpful. You may also try anti-inflammatory medicines. You can try custom-made orthotics, physical therapy, and night splints for pain that doesn’t go away. You can also try corticosteroid injections into the heel. You rarely need surgery.