Plantar Fasciitis

What Causes Plantar Fasciitis?

Your plantar fascia is a thick band of tissue that runs along the bottom of your foot. It connects your heel bone to the base of your toes. Like a bowstring, it supports your arch and absorbs shock with every step.

When too much stress builds up, tiny tears can form where the plantar fascia attaches to your heel. The tissue becomes irritated and inflamed. That irritation causes the pain and stiffness of plantar fasciitis.

Several everyday habits can put extra strain on this tissue.

Poor Footwear

Shoes with thin soles or little arch support force your plantar fascia to absorb more impact. Flip-flops, flat sandals and worn-out sneakers are common culprits. Walking barefoot on hard floors or pavement can have the same effect.

Tight Calves

Your calf muscles connect to your heel through the Achilles tendon. When you have tight calves, they pull on your heel and increase tension along the bottom of your foot. People who often wear high heels or sit for long periods are more likely to have tight calf muscles.

Sudden Increases in Activity

Your feet need time to adjust to new demands. Starting a running program, adding miles too quickly or taking long walks on vacation can overload the plantar fascia. Also, a new job that keeps you standing on concrete all day can do the same. If you are training for a race or picking up a new sport, a sports medicine specialist can help you build up safely.

Other Risk Factors

You are more likely to develop plantar fasciitis if you:

• Are between ages 40 and 60
• Carry extra body weight
• Have flat feet, high arches or an unusual walking pattern
• Work on your feet on hard surfaces

At-Home Relief and Stretching

Most people with plantar fasciitis improve without surgery. Simple changes at home can ease foot pain and give the tissue a chance to heal.

Give Your Feet a Break

• Cut back on high-impact activity — Swap running or jumping for gentler activities until the pain reduces.
• Ice your heel — Roll your foot over a frozen water bottle for 10 to 15 minutes a few times a day.
• Switch to supportive shoes — Choose shoes with firm heel cushioning and good arch support, even around the house.
• Try shoe inserts — Over-the-counter heel cups or arch support inserts can take pressure off your heel.
• Ask about pain relievers — Over-the-counter anti-inflammatory medicine may help in the short term.

Plantar Fasciitis Stretches to Try

Stretching loosens tight tissue in your foot and calf. Do these plantar fasciitis stretches two to three times a day, especially before your first steps in the morning. You should feel a gentle pull, not sharp pain.

• Towel stretch — Before you get out of bed, loop a towel around the ball of your foot. Keep your knee straight and gently pull the towel toward you. Hold for 30 seconds and repeat three times.
• Wall calf stretch — Stand facing a wall with your hands on it. Step one foot back, keep that heel on the floor and bend your front knee. Hold for 30 seconds, then switch sides.
• Toe stretch — Sit and cross one foot over your opposite knee. Gently pull your toes back toward your shin until you feel a stretch along your arch. Hold for 15 to 30 seconds.
• Ball roll — While seated, roll a tennis ball or golf ball under your arch for one to two minutes.

Dr. Moustafa noted, “Consistent stretching and strengthening exercises, along with supportive footwear, are the foundation of treatment. While patients may start noticing improvement within a few weeks, full recovery can often take several months."

When to See a Specialist

Home care works for most people, but some heel pain benefits from an exam by a specialist. Make an appointment with a podiatrist or orthopedic specialist if you experience the following symptoms.

These symptoms require urgent evaluation:

 You cannot put weight on your foot

• Your pain started after an injury
• You have numbness, tingling or swelling in your foot

 If you have diabetes, call your provider right away about any foot pain. Diabetes can reduce feeling in your feet, so small problems can turn serious quickly.

These symptoms require more routine evaluations:

•  Pain gets worse or keeps you from daily activities
• Heel pain lasts more than a few weeks despite home care

A physician will examine your foot and ask about your symptoms. In some cases, they may order an X-ray or ultrasound to rule out other problems, like a stress fracture. From there, they can recommend plantar fasciitis treatment based on your needs.

 Physical Therapy

A physical therapist can create a stretching and strengthening plan designed for your feet and legs. Physical therapy may also include taping techniques, massage and guidance on proper footwear. Stronger muscles in your feet and calves help share the load with your plantar fascia.

Night Splints

A night splint holds your foot in a flexed position while you sleep. This keeps your plantar fascia and calf gently stretched overnight. Many people find their first steps in the morning are less painful when they wear one.

Medical Treatments for Persistent Pain

When pain lasts despite several months of physical therapy and home care, other treatments can help.

 Custom orthotics

Shoe inserts molded to your feet provide targeted support and cushioning. (Over- the-counter inserts work just as well for most patients.)

 Shockwave therapy

Sound waves stimulate healing in the damaged tissue.

 Steroid injections

A shot of anti-inflammatory medicine into the heel can ease pain for several weeks or months. Dr. Moustafa added, “I generally reserve these as a last resort due to the potential risks of plantar fascia rupture and heel fat pad atrophy.”

 Surgery

In rare cases, a surgeon may release part of the plantar fascia to relieve tension.

 “Persistent heel pain can change the way you walk and sometimes contribute to discomfort in your knees, hips or back. Addressing symptoms early can help you stay active and avoid prolonged limitations,” said Dr. Moustafa.

Learn more about the advanced orthopedic and sports medicine services at Catholic Health.

 Frequently Asked Questions About Plantar Fasciitis

 Can plantar fasciitis go away on its own?

Sometimes, but it can take a long time without treatment. Rest, stretching and supportive shoes help most people recover faster. Pushing through the pain can make the condition last longer.

 Is walking good for plantar fasciitis?

Gentle walking in supportive shoes is usually fine. Avoid long walks, hills and hard surfaces while your heel is sore. If walking makes your pain worse, try swimming or cycling until it improves.

 Are plantar fasciitis and heel spurs the same thing?

No, but they are related. A heel spur is a small bony growth on the heel bone. Many people with plantar fasciitis have heel spurs, but the spur itself usually does not cause the pain. Treatment focuses on the irritated tissue, not the spur