Plantar fasciitis is a common cause of heel pain and is caused by the tearing or over stretching of the plantar fascia ligament, a fibrous length of tissue that runs from the heel to the ball of the foot. During activity, the ligament stretches and contracts like a rubber band, bearing the weight of the entire body. When injured or overworked, it can become inflamed and painful. These injuries generally occur close to the calcaneous, or heel bone.
Signs include pain that gradually builds throughout the day, or after standing, walking or running for a prolonged period. Pain is often sharpest in the morning due to a tightening of the ligaments overnight, gradually lessening as the ligament loosens. There may be swelling of the underside of the foot or heel, an inability to flex the toes upward, or pain in only one foot.
Athletes who do not stretch before working out or who suddenly raise the difficulty of their workouts are susceptible, as are those who jump or run excessively. In non-athletes, ill-fitting footwear with poor arch and heel support is the most common cause. Obesity and pregnancy also contribute to the condition, as the extra weight adds to the ligament's already heavy workload.
Other causes are arthritis, diabetes, age, abnormal gait, high arches, or flat feet. Overly tight calf muscles can also agitate the fascia--one reason athletes stretch before any sort of exercise, including walking. Standing barefoot on a hard surface for any length of time will stress the feet, as will high-heeled shoes or boots.
Plantar fasciitis treatment is non-invasive in all but the most extreme cases, and it begins with a reduction of activity--a cessation to all actions that cause stress to the feet. Continuing with an exercise regimen that agitates the ligament will prevent healing. Elevation, icing and anti-inflammatory medications - usually over the counter will reduce pain during a flare-up.
In more tenacious cases, when rest alone does not help, special splints can be worn at night; these prevent the fascia from contracting and promote healing. Shoe inserts can add support during the day, though orthotic shoes are the superior choice for long-term plantar fasciitis treatment and are almost a necessity for persons susceptible to any sort of ongoing foot issue.
When plantar fasciitis is not promptly or completely treated, it may worsen and eventually require surgery. Prevention is critical. Slow progression during exercise, a decrease in running and an increase in biking and swimming, properly-fitting and supportive shoes with plenty of cushion, and managed weight are all crucial to healthy feet.
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