Plantar Fasciitis

Article Translations: (Spanish)

Emily wasn't sure how she let her friend talk her into signing up for a 10-mile race. The most she'd ever jogged was 3 miles. Now, with just a few days to go before the race, Emily felt woefully unprepared, so she jogged 6 miles one day and then 8 the next to get ready.

The morning of the race, Emily's heel hurt a little bit when she woke up, but she still joined her friend and made it the full 10 miles. The next day her heel was in so much pain that she could barely walk, so Emily went to see a doctor. The doctor asked her some questions about her activities, then told Emily she had a condition called plantar fasciitis.

What Is Plantar Fasciitis?

At the bottom of your foot there's a thick band of connective tissue called the plantar fascia or arch tendon. It connects your heel bone (calcaneus) to the front of your foot.

If the plantar fascia becomes irritated and sore from overuse, it's known as plantar fasciitis. Plantar fasciitis sometimes can be mistaken for heel spurs, which is a different kind of injury with similar symptoms.

Plantar fasciitis is a common cause of heel pain in runners, dancers, and athletes in sports that involve a lot of running or jumping.

You don't have to be active to get plantar fasciitis. It can affect anyone. People who are overweight, pregnant women, people whose jobs involve a lot of standing, and people who wear worn-out shoes all have a higher chance of getting plantar fasciitis.

What Are the Symptoms?

The most obvious symptom of plantar fasciitis is a sharp pain on the bottom of the foot, near the heel. Here are some signals that this pain may be plantar fasciitis:

• The pain is strongest first thing in the morning but gets better after a few minutes of walking around.
• The pain is worse after standing for a long time or after getting up from sitting.
• The pain develops gradually and becomes worse over time.
• The pain is worse after exercise or activity than it is during activity.
• It hurts when stretching the foot.
• It hurts when pressing on the sides of the heel or arch of the foot.

What Do Doctors Do?

If you see a doctor for heel pain, he or she will first ask questions about where you feel the pain. If plantar fasciitis is suspected, the doctor will ask about what activities you've been doing that might be putting you at risk. The doctor will also examine your foot by pressing on it or asking you to flex it to see if that makes the pain worse.

If something else might be causing the pain, like a heel spur or a bone fracture, the doctor may order an X-ray to take a look at the bones of your feet. In rare cases, if heel pain doesn't respond to regular treatments, the doctor also might order an MRI scan of your foot.

The good news about plantar fasciitis is that it usually goes away after a few months if you do a few simple things like stretching exercises and cutting back on activities that might have caused the problem. Taking over-the-counter medicines can help with pain. It's rare that people need surgery for plantar fasciitis. Doctors only do surgery as a last resort if nothing else eases the pain.

What Causes Plantar Fasciitis?

Because the plantar fascia supports your foot and gets used every time you take a step, it has to absorb a large amount of stress and weight. If too much pressure is put on the plantar fascia, the fibers can become damaged or start to tear. The body responds by causing inflammation in the affected area. This is what causes the pain and stiffness of plantar fasciitis.

Things that can increase the risk of plantar fasciitis include:

• Tight calf muscles. Tight calves make it harder to flex your foot, and this puts more stress on the plantar fascia.
• Weight. Carrying a few extra pounds puts added pressure on your feet every time you take a step.
• Activities that put a lot of stress on the feet. This includes things like running, hiking, dancing, and aerobics.
• Bad shoes. Footwear that doesn't give your foot the support it needs increases your risk of plantar fasciitis. You'll want to ditch any shoes that have thin soles or inadequate arch support, or ones that don't fit your feet properly. Routinely wearing high heels can also cause your Achilles tendon to contract over time, making it harder to flex your foot.
• Jobs that involve a lot of standing or walking on hard surfaces. Jobs that keep you on your feet all day, like waiting tables or working in a store, can cause damage to your plantar fascia.
• High arches, flat feet, or other foot problems. The shape of your foot can affect the way your weight is distributed on your feet when you stand. If weight distribution is a bit off, it can add to a person's risk of plantar fasciitis. How someone walks can increase the stress on certain parts of the foot too.

Can I Prevent Plantar Fasciitis?

More than with most sports injuries, a little bit of prevention can go a long way toward keeping you free from plantar fasciitis. Here are some tips to follow:

• Wear supportive shoes that fit you well. When your shoes start to show wear and can no longer give your feet the support they need, it's time to get a new pair. Runners should stop using their old shoes after about 500 miles of use. Have a trained professional at a specialty running store help you find the right pair for your foot type, and then keep your shoes tied and snug when you wear them.
• Stay in good shape. By keeping your weight in check, you'll reduce the amount of stress on your feet.
• Stretch your calves and feet before you exercise or play a sport. Ask an athletic trainer or sports medicine specialist to show you some dynamic stretching exercises.
• Start any new activity or exercise slowly and increase the duration and intensity of the activity gradually. Don't go out and try to run 10 miles the first time you go for a jog. Build up to that level of exercise gradually.

Talk to your doctor about getting heel pads, custom shoe inserts, or orthotics to put in your shoes. Foot supports can help cushion your feet and distribute your weight more evenly. This is especially true for people with high arches or flat feet. Your doctor will be able to tell you if shoe inserts and supports might lower your chances of heel injury.

Treating Plantar Fasciitis

Treatments you can do at home include:

• Rest. Try to avoid activities that put stress on your feet. This can be hard, especially if your job involves being on your feet for hours at a time, but giving your feet as much rest as possible is the first step in reducing the pain of plantar fasciitis.
• Use ice or a cold compress to reduce pain and inflammation. Do this three or four times a day for about 20 minutes at a time until the pain goes away.
• Take anti-inflammatory medications. Painkillers such as ibuprofen or acetaminophen can help relieve pain and reduce inflammation in the affected area. Your doctor may also prescribe a medication called a corticosteroid to help treat severe pain.
• Exercise your feet and calves. When the pain is gone, do calf and foot stretches and leg exercises to make your legs as strong and flexible as possible. This can help you avoid getting plantar fasciitis again. Ask your coach, athletic trainer, or a physical therapist to show you some leg exercises. Rolling a tennis ball under your foot can massage the area and help the injury heal.
• Talk to your doctor about shoe inserts or night splints. Shoe inserts can give your feet added support to aid in the healing process. Night splints keep your calf muscles gently flexed, helping to keep your plantar fascia from tightening up overnight.
• Have a trainer or sports injury professional show you how to tape your foot. A proper taping job allows your plantar fascia to get more rest. You should tape your foot each time you exercise until the pain is completely gone.

For people who get repeated sports injuries, it can help to see a sports medicine specialist. These experts are trained in evaluating things like an athlete's running style, jumping stance, or other key moves. They can teach you how to make the most of your body's strengths and compensate for any weaknesses.

Once you're healed, look for the silver lining in your bench time. You may find that what you learn from having an injury leads you to play a better game than ever before.

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