Plantar fasciitis

What is the Plantar Fascia?

The plantar fascia is a thick, fibrous band of tissue that runs along the bottom of the foot from the heel to the base of the toes, acting as a support and shock absorber for the arch.

However, when excessive strain is placed on the foot, microtears and scar tissue form in the plantar fascia, resulting in inflammation, irritation, and pain on the bottom of the foot, towards the back of the arch. This is also known as Plantar Fasciitis.

What may have caused it?

The most common causes are improper foot support (eg: high heels, thin-soled shoes, etc), poor biomechanics of ankles, knees and/or hips when walking, and excessive physical activity without proper foot support, warm-up and cool down.

When does it usually hurt the most?

The pressure of your first steps out of bed in the morning can be especially painful because the body tries to heal the fascia while at rest and then the weight of the body places a stress on the tissues when walking. Pain is also common in the evening, particularly after a full day of physical activity.

How can the pain be addressed?

Ideally, the cause would be addressed first, by reducing the stress on the fascia with proper foot support and activity modification. Techniques to implement at home include: 1. Before getting up in the morning, sit on the edge of the bed and rest your feet on a heating pad for 5-10 minutes to increase the circulation to the foot. Tip: Keep the heating pad near the bed to avoid walking around to find it. 2. At the end of the day, while sitting down, roll a bottle of ice under the arch of your foot for 5 minutes to reduce inflammation. Tip: Keep a small water bottle in the freezer at all times. 3. Gentle stretching of the calf muscle, and massage to the foot is also beneficial. Patience and compliance are the keys to overall healing.

What happens if the pain doesn’t go away?

A licensed professional, such as a Physical Therapist or Podiatrist, can conduct a thorough evaluation to determine the severity of the condition and can do a structural assessment. Physical Therapy is the most conservative approach that addresses the pain, structural and biomechanical abnormalities, and gait analysis without pharmaceutical interventions, injections or surgery. However, if the condition does not improve in a reasonable amount of time, then the Physical Therapist would refer the patient to a Podiatrist to consider a more aggressive approach. Typically, insurance companies require that patients undergo conservative treatment for Plantar Fasciitis, such as Physical Therapy, before expensive procedures are approved.

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